Biologicals to Treat Allergy and Asthma

In 2003, anti-immunoglobulin E (omalizumab) was registered for the treatment of mild to moderate allergic asthma. In 2015, anti-interleukin-5 (mepolizumab) followed with registration for the treatment of severe eosinophilic asthma. These biologicals are medicinal products made partially or totally of naturally occurring molecules, such as antibodies, cytokines, or receptors and have a favorable safety profile and low incidence in adverse events compared to conventional asthma treatments. Therefore, anti-IgE and anti-IL-5 treatment fulfills an unmet need of specific subgroups of patients that do not respond to the classical inhaled steroid-based treatment many of whom need on systemic glucocorticoid treatment. The severe long-term effects of systemic glucocorticoid use in these patients make biologicals a promising alternative.There are other biologicals for the treatment of allergies and asthma in the process of clinical testing among which anti-interleukin-4 receptor α-blockers, anti-interleukin-13, chemoattractant homologous receptor 2 antagonists, and thymic stromal lymphopoietin blockers. Every biological affects the immune system in a different way and the key message learned from the undertaken randomized controlled trials has been to select the right patient for the right treatment. This leads to a continuous search for biomarker-biological associations. In this article we evaluate biologicals registered for the treatment of allergies and asthma and review the clinical effects of biologicals that are in the process of clinical testing.