Asthma is a chronic inflammatory disorder characterized by reversible airflow obstruction, and it is increasingly being recognized as a broad-spectrum disease encompassing multiple patient characteristics and pathophysiologic mechanisms. Asthma control that is suboptimal increases the burden of healthcare costs and reduces societal productivity. In poorly controlled allergic and eosinophilic asthma, biologic therapies targeting IgE and eosinophils can be used. The goal of this review is to examine the advancements in currently available biologic therapies for asthma that target IgE and eosinophils, as well as how these therapies may impact overall healthcare costs. Omalizumab is an anti-IgE antibody that is authorized for the treatment of moderate-to-severe asthma that is poorly managed. Many studies have shown that omalizumab not only improves quality of life and symptom ratings, but it also reduces urgent care and emergency department visits, as well as hospitalizations. Mepolizumab, reslizumab, and benralizumab all target IL-5, a cytokine that is important for eosinophils. These biologic medicines improve asthma symptoms, minimize exacerbations, and decrease emergency visits and hospitalizations in individuals with poorly managed eosinophilic asthma.
Poorly managed severe asthma affects a tiny proportion of asthma patients in the United States, but it accounts for a substantial proportion of healthcare consumption. Biological treatments have been found to minimize healthcare use, including emergency visits and hospitalizations, in patients with poorly managed severe persistent asthma. Biologic drugs clearly have a positive role in the therapy of severe asthma, and additional research should be conducted to determine optimal patient features for the different agents, as well as overall benefit in terms of healthcare usage and cost.