Treatment options

Treatment options

In patients with mild or moderate asthma, type 2 inflammation rapidly improves when inhaled corticosteroids (ICS) are taken regularly and correctly.1

While in severe asthma, type 2 inflammation may be relatively refractory to high dose ICS. It may respond to oral corticosteroids but their serious adverse effects mean that alternative treatments should be sought.1

Since type 2 inflammation is driven by cytokines, including IL-4, IL-5, and IL-13, the Global Initiative for Asthma (GINA) Guidelines recommends add-on type 2 biologic therapy for patients with exacerbations or poor symptom control on high-dose ICS/LABA who have the following criteria of type 2 inflammation:1

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Consider if an add-on biologic targeting the type 2 inflammation pathway would be beneficial.

A range of biologic agents are now registered in Australia to treat severe asthma, targeting different components of type 2 inflammation.2-5 Clinicians will need weigh up the patient’s characteristics and available clinical data when making treatment decisions.

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Eligibility criteria and predictors of good response for various biologic therapies.2-5
 

Adapted from the Global Initiative for Asthma (GINA). Difficult-to-treat & severe asthma in adolescent and adult patients: diagnosis and management. A GINA pocket guide for health professionals, V2.0 April 2019.

*Not registered In Australia for nasal polyposis

References

  1. 1.1. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2020. Available from: www.ginasthma.org (accessed November 2020).
  2. 2.2. Australian Product Information Xolair (omalizumab), 2020.
  3. 3.3. Australian Product Information Nucala (mepolizumab) 2019.
  1. 4.4. Australian Product Information Fasenra (benralizumab) January 2020.
  2. 5.5. Australian Approved Product Information for Dupixent (dupilumab). 6 October 2020.