Biologic therapy for severe asthma: an update

Abstract

Asthma is a heterogeneous disease with a complex pathophysiology that manifests with different
phenotypes and endotypes. Severe asthma, resistant to treatment with high doses of inhaled steroids, is an
uncommon entity but it implies a great medical challenge. Progress in the knowledge of the
pathophysiology of asthma has allowed the development of new and more individualized therapy with
biologics in the context of precision medicine. Most of these targeted biologic therapies for have been
developed for asthma type-2 high, mainly eosinophilic, but there are fewer developments for non-T2
asthma, whose mechanisms are not completely elucidated. This review attempts to compile the most recent
evidence about the use of biologic therapies in severe asthma, with special emphasis on its mechanisms of
action, indications, clinical efficacy and possible adverse effects.