Advancing precision medicine in asthma: Evolution of treatment outcomes

• Published in: Journal of allergy and clinical immunology 2023-10, Vol.152 (4), p.835-840
• Main Authors: Canonica, Giorgio Walter, Varricchi, Gilda, Paoletti, Giovanni, Heffler, Enrico, Virchow, Johann Christian
• Format: Article
• Language: English
• Subjects: Airways remodeling; allergen immunotherapy; asthma treatments; biologics; clinical remission
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/j.jaci.2023.07.009

The article discusses the historical evolution of asthma treatment and highlights recent advancements in personalized medicine, specifically the use of biologics in severe asthma therapy and its potential combination with allergen immunotherapy (AIT). One of the major breakthroughs of biologics is their potential effect on airway remodeling, a crucial aspect of asthma chronicity. The article introduces the concept of disease-modifying antiasthmatic drugs, which aim to modify the course of asthma and possibly modulate or prevent airway remodeling. Furthermore, the critical importance of patient-centered outcome measures to evaluate the efficacy and effectiveness of asthma treatments is emphasized, with the innovative concept of asthma remission introduced as a potential outcome. Recent studies suggest that AIT can be used as an additional therapy to biologic agents for the treatment of allergic asthma. The combination of these treatments has been shown to induce improved clinical outcomes. However, AIT is actually not recommended for use in patients with severe asthma, but encouraging results from studies investigating the combined use of AIT and biologics indicate a novel approach to exploring these treatment modalities. In conclusion, the introduction of biologics and AIT has changed the scenario of respiratory allergy treatment, from a “one size fits all” approach to embracing “individual treatments.”