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Asthma Management in Adults

Authors :
William W, Busse
Mario, Castro
Thomas B, Casale
Source :
The Journal of Allergy and Clinical Immunology: In Practice. 11:21-33
Publication Year :
2023
Publisher :
Elsevier BV, 2023.

Abstract

Management of asthma in adults has advanced in the past 10 years. Central to these advances has been further clarification of type (T) 2 mechanisms of airway inflammation and utilization of T2 biomarkers, that is, eosinophils and fractional exhaled nitric oxide. In addition, epithelial cells are emerging as significant contributors to inflammation through generation of alarmins to initiate local injury as well as downstream pathways. Five new biologics, mepolizumab, benralizumab, reslizumab, dupilumab, and tezepelumab, were approved to join omalizumab and revolutionize severe asthma treatment. These biologics significantly prevent exacerbations to spare systemic corticosteroids use and their side effects. Guidelines attest to the effectiveness of inhaled corticosteroids/long-acting β-agonists (formoterol) for both maintenance and rescue therapy. Focused updates to the Expert Panel Report addressed limited but specific questions relevant to asthma control. Future guidelines should include phenotype/endotype-directed therapeutics to gain more precision-directed treatment.

Subjects

Subjects :
Immunology and Allergy

Details

ISSN :
22132198
Volume :
11
Database :
OpenAIRE
Journal :
The Journal of Allergy and Clinical Immunology: In Practice
Accession number :
edsair.doi.dedup.....3ba55371fb8e8afbd659c8a1952995c1