Abstract
Standard therapy of moderate to severe persisting bronchial asthma consists in anti-inflammatory treatment with inhaled corticosteroids in combination with longacting bronchodilators and leukotriene antagonists. Some patients do not attain control of their disease in spite of the standard therapy.
There has been a dramatic increase in the number of studies using biological therapy over the last two decades. There are now three molecules with selective approaches to allergic and eosinophilic airway inflammation available in the clinical practice.
In patients with severe asthma with frequent exacerbations biological therapy targeting the interleukin-5 pathway (mepolizumab, reslizumab) or immunoglobulin E (omalizumab) results in markedly improved asthma control. Addition of the new molecules to treatment of severe disease requires experienced clinical judgement as the molecules overlap in some of their effects.
The present overview summarises both present and future options of biological therapy in patients with severe asthma.