Introduction: Patients with severe asthma experience a significant burden of symptoms, disease exacerbations and medication side-effects. Severe asthma interferes with the patients’ quality of life and has high health-care costs. New targeted biologic therapies have improved the management of severe asthma by significantly reducing exacerbations and maintenance corticosteroid use, and also improving lung function and patient quality of life.

Areas covered: Not all severe asthmatics are eligible for such therapies. Those with allergic and eosinophilic asthma, usually referred to as “T2-high” asthma benefit from anti-IgE and anti-IL-5/5R antibodies respectively, whereas some asthmatics are eligible for both: “overlap” endotype. In this review, we present briefly the monoclonal antibodies that have been approved in the management of severe asthma and we focus on the “overlap” endotype.

Expert Opinion: Since these therapies are costly, it is extremely important to choose the right treatment for the right patient especially in the “overlapping” one. The decision is mainly based on the judgment of the clinician and is often driven by the most easily obtainable biomarker, thus the blood eosinophil count. Comorbidities, patient’s input and administration frequency may aid the decision of choosing one over another biologic.

简介：患有严重哮喘的患者会承受很大的症状，疾病加重和药物副作用的负担。严重的哮喘会影响患者的生活质量，并增加医疗费用。新的针对性生物疗法通过显着减少病情加重和维持皮质类固醇使用，并改善了肺功能和患者生活质量，改善了严重哮喘的管理。

覆盖的区域：并非所有严重的哮喘病患者都有资格接受此类治疗。那些患有变应性和嗜酸性哮喘的人，通常被称为“ T2高”哮喘，分别受益于抗IgE和抗IL-5 / 5R抗体，而某些哮喘患者符合以下两种条件：“重叠”内型。在本文中，我们简要介绍了已在重度哮喘治疗中获准的单克隆抗体，并且我们将重点放在“重叠”内型上。

专家意见：由于这些疗法的成本很高，因此为正确的患者选择正确的治疗非常重要，尤其是在“重叠”疗法中。该决定主要基于临床医生的判断，并且通常由最容易获得的生物标志物决定，因此血液嗜酸性粒细胞计数。合并症，患者的输入和给药频率可能有助于决定选择一种生物制剂还是另一种生物制剂。