Advancing Care in Severe Asthma: The Art of Switching Biologics

Highlights What are the main findings? Switching between different monoclonal antibodies can be beneficial for patients with severe asthma, especially when the initial biologic therapy does not provide sufficient symptom control or presents severe side effects. Considering individual patient factors and biomarkers in determining the effectiveness of biologics is fundamental. This personalized approach helps predict positive responses and optimize treatment efficacy. What is the implication of the main finding? The need for a more personalized approach in severe asthma treatment, using patient-specific characteristics and biomarker assessment to guide the selection and switching of biologics. The importance of flexibility in treatment strategies for severe asthma, acknowledging the dynamic nature of the disease and the evolving landscape of biologic therapies.Highlights What are the main findings? Switching between different monoclonal antibodies can be beneficial for patients with severe asthma, especially when the initial biologic therapy does not provide sufficient symptom control or presents severe side effects. Considering individual patient factors and biomarkers in determining the effectiveness of biologics is fundamental. This personalized approach helps predict positive responses and optimize treatment efficacy. What is the implication of the main finding? The need for a more personalized approach in severe asthma treatment, using patient-specific characteristics and biomarker assessment to guide the selection and switching of biologics. The importance of flexibility in treatment strategies for severe asthma, acknowledging the dynamic nature of the disease and the evolving landscape of biologic therapies.Abstract Biologics targeting IgE, IL-5, IL-4/IL-13, and TSLP are crucial in severe asthma treatment. Research, including randomized controlled trials and real-world studies, has been conducted to assess their efficacy and identify patient characteristics that may predict positive responses. The effectiveness of switching biologics, especially given overlaps in treatment eligibility, and the clinical outcomes post-cessation are critical areas of investigation. This work reviews the effects of switching between these biologics and the indicators of treatment success or failure. Insights are primarily derived from real-world experiences, focusing on patients transitioning from one monoclonal antibody to another. Moreover, this review aims to provide insights into the effectiveness, safety, and broader implications of switching biologics, enhancing understanding for clinicians to optimize severe asthma management. The article underlines the importance of a patient-centered approach, biomarker assessment, and the evolving nature of asthma treatment in making informed decisions about biologic therapy.