Utilizing Predictive Inflammatory Markers for Guiding the Use of Biologicals in Severe Asthma

Abstract

Martin Runnstrom,1 Hilary Pitner,2 Jennifer Xu,2 F Eun-Hyung Lee,1 Merin Kuruvilla1 1Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA, USA; 2Department of Medicine, Emory University, Atlanta, GA, USACorrespondence: Merin Kuruvilla Email [email protected]: Asthma is a chronic respiratory disease characterized by chronic airway inflammation and airflow obstruction. Up to ten percent of asthmatics have severe asthma, and many remain uncontrolled despite optimal medical management. With our increased understanding of the heterogeneity of asthma and its complex pathophysiology, several biomarkers have been developed and in the recent past, several biologic therapies for severe asthma have been developed and are now in widespread use. Although these biological agents have shown great benefit in treating severe asthma, not all patients respond equally well, and some do not derive any benefit. As much of the current literature of these medications have not assessed biomarkers or have used different cutoffs, it is often challenging to decide the best medication for an individual patient. Here, we review common asthma subtypes, current available biologic therapies for asthma, the clinical application of currently available type 2 biomarkers, as well as summarizing the evidence on how patient characteristics and biomarkers can help with choosing the optimal biologic for a patient that has the highest likelihood of success.Keywords: asthma, biomarkers, biologics, eosinophils, immunoglobulin E, fractional exhaled nitric oxide

Keywords

• asthma – biomarkers – biologics – eosinophils – immunoglobulin e – fractional exhaled nitric oxide