Biologic Therapies for Allergic Asthma Management

Biologic therapies have transformed the management of allergic asthma by targeting specific mediators of type 2 inflammation. These agents, principally monoclonal antibodies directed against immunoglobulin E (IgE) or interleukin pathways such as IL-5 and the IL-4/IL-13 receptor, offer precision treatment for patients whose disease remains uncontrolled by conventional inhaled corticosteroids and bronchodilators. By neutralising circulating IgE, depleting eosinophils or blocking key cytokine receptors, biologics reduce exacerbation rates, improve lung function and allow tapering of systemic corticosteroids. Their introduction has prompted a paradigm shift towards endotype-guided care, with biomarkers such as blood eosinophil count, serum periostin and fractional exhaled nitric oxide employed to predict response. Global trials and real-world registries confirm sustained benefits over years of follow-up and a favourable safety profile, although rare hypersensitivity and infectious complications require vigilance. These therapies now form essential options for severe allergic asthma, enhancing quality of life and reducing healthcare burden worldwide.

Research from Nature Portfolio

Large-scale pharmacovigilance analyses have quantified the risk of anaphylactic reactions associated with current asthma biologics. A global real-world study examined individual case safety reports over five decades, revealing disproportionate signals for anaphylaxis with anti-IgE, anti-IL-5 and anti-IL-5 receptor agents, whereas anti-IL-4/IL-13 receptor therapy demonstrated a lower risk profile. Serious events comprised the majority of reports, underscoring the need for post-administration monitoring protocols. These findings refine the safety landscape of targeted therapies and support risk-mitigation strategies such as extended observation periods and patient education on recognising early hypersensitivity signs.

Biologic Therapies for Allergic Asthma Management publication trend

The graph below shows the total number of articles in biologic therapies for allergic asthma management across all publications each year (not limited to Nature Index journals).

Technical terms

Biologic therapy: A treatment derived from living organisms, typically a monoclonal antibody, designed to target specific immune pathways.

Monoclonal antibody: A laboratory-produced molecule engineered to bind a single antigen epitope with high specificity.

Immunoglobulin E (IgE): An antibody class central to the allergic response and mast cell activation.

Type 2 inflammation: An immune cascade driven by Th2 cells and characterised by cytokines IL-4, IL-5 and IL-13, eosinophilia and elevated IgE.

Anaphylaxis: A severe, rapid-onset systemic hypersensitivity reaction that can be life-threatening without prompt intervention.

References

1. Parasitic infections related to anti-type 2 immunity monoclonal antibodies: a disproportionality analysis in the food and drug administration’s adverse event reporting system (FAERS). Frontiers in Pharmacology (2023).
2. Perceptions on Home-Administration of Biologics in the Context of Severe Asthma: An International Qualitative Study. The Journal of Allergy and Clinical Immunology In Practice (2022).
3. Hypersensitivity reactions to biologics used in the treatment of allergic diseases: clinical features, diagnosis and management. Frontiers in Allergy (2023).
4. A risk of serious anaphylatic reactions to asthma biologics: a pharmacovigilance study based on a global real-world database. Scientific Reports (2023).