Pragmatic and Observational Research (Mar 2024)
Difficult-To-Treat and Severe Asthma: Can Real-World Studies On Effectiveness of Biological Treatments Change the Lives of Patients?
Abstract
Corrado Pelaia,1 Antonio Giacalone,2 Gianluca Ippolito,2 Daniela Pastore,2 Angelantonio Maglio,3 Giovanna Lucia Piazzetta,1 Nadia Lobello,1 Nicola Lombardo,1 Alessandro Vatrella,3 Girolamo Pelaia2 1Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, Catanzaro, Italy; 2Department of Health Sciences, University “Magna Græcia” of Catanzaro, Catanzaro, Italy; 3Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, ItalyCorrespondence: Corrado Pelaia, Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa – Località Germaneto, Catanzaro, 88100, Italy, Tel + 39 0961 3647007, Email [email protected]: Many different phenotypes that characterize severe asthma are supported by intricate pathomechanisms called endotypes. The latter are driven by molecular interactions, mediated by intercellular networks. With regard to the biological treatments of either allergic or non-allergic eosinophilic type 2 asthma, real-world studies have confirmed the positive effects of currently available antibodies directed against immunoglobulins E (IgE), interleukin-5 (IL-5) and its receptor, as well as the receptors of interleukins-4 (IL-4) and 13 (IL-13). The best way to treat severe asthma should be chosen based on the peculiar phenotypic and endotypic traits of each patient. This will lead to relevant improvements in both clinical and functional outcomes. In particular, biological therapies can change the lives of asthma patients with a strong impact on quality of life. Unfortunately, patients with severe non-type-2 asthma, who continue to have pertinent unmet needs, are not receiving satisfactory advances within the context of biological treatments. It is also hopeful that in the next future new therapeutic strategies will be specifically implemented for these people, perhaps offering them the opportunity to improve their current, mostly inadequate asthma management.Keywords: type 2 severe asthma, monoclonal antibodies, pro-inflammatory cytokines, quality of life