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Advanced Management Strategies in Severe Asthma an ...
Choosing the Right Biologic for the Right Patient ...
Choosing the Right Biologic for the Right Patient KRAFT
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The document provides a comprehensive guide on selecting the appropriate biologic therapy for patients with severe asthma, authored by Monica Kraft, MD. The main objectives are to identify asthma phenotypes and endotypes, and to choose suitable biologics for personalized treatment of severe asthma. Severe asthma is defined as a condition that remains uncontrolled despite optimized therapy, and it might deteriorate when high-dose treatments are reduced.<br /><br />The document highlights different asthma phenotypes, such as eosinophilic and non-eosinophilic types, and suggests using precision medicine approaches to tailor treatments accordingly. It emphasizes the role of biomarkers, including FeNO, blood eosinophils, and IgE, in identifying the type of asthma and predicting treatment responses. These biomarkers help in differentiating between Type 2 and non-Type 2 asthma and guide the choice of biologics.<br /><br />There are six FDA-approved biologics for severe asthma, each targeting specific pathways and suitable for different patients based on their biomarker profiles. These include omalizumab, reslizumab, mepolizumab, benralizumab, dupilumab, and tezepelumab. The document discusses predictive biomarkers associated with the efficacy of these biologics and underscores the importance of regular monitoring and adjustments in therapy based on patient responses.<br /><br />The selection and switching algorithms for biologic therapies are described, considering factors like blood eosinophil count, FeNO levels, and patient history. The document emphasizes the ongoing need to refine asthma management strategies through better understanding of immunophenotyping, acknowledging gaps where patients still experience suboptimal responses to current biologic therapies. Finally, it calls for ongoing evaluation and optimization of biologic treatments to improve outcomes for patients with severe asthma.
Keywords
severe asthma
biologic therapy
asthma phenotypes
precision medicine
biomarkers
FDA-approved biologics
eosinophilic asthma
personalized treatment
asthma management
immunophenotyping
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