Management of Uncontrolled Asthma: A Framework for Novel and Legacy Biologic Treatments

Abstract

Asthma continues to be a complex respiratory disease to control for many despite optimal standard inhaler therapy. The increased dependence on steroid-sparing biologic treatments in the 21^st century has created a dilemma between identifying the patient’s intrinsic biomarkers and their “life markers.” With Tezepelumab being the most recent FDA-approved biologic for asthma, it is even more critical for asthma specialists to better understand and establish a framework to determine which biologic would work best for their patients. While cost and payor approvals limit access to certain asthma biologics, medical decisions on which biologic to select should be centered around shared decision-making, the rationale for biologic initiation, and critical biologic education to help achieve successful asthma control.

Keywords:

• severe asthma
• Tezepelumab
• asthma biologic
• shared decision making
• asthma

Disclosure

Dr Mario Castro reports grants from NIH, grants from ALA, grants from PCORI, grants, personal fees from AstraZeneca, grants, personal fees from GSK, grants, personal fees from Novartis, grants from Pulmatrix, grants, personal fees from Sanofi-Aventis, grants from Shionogi, personal fees from Elsevier, personal fees from Genentech, personal fees from Teva, personal fees from Amgen, personal fees from Regeneron, during the conduct of the study. The authors report no other conflicts of interest in this work.