Severe Asthma: Moving from Phenotype to Endotype Classification with Updates on Treatment

Abstract

Asthma has classically been categorized into several phenotypes to address the complexities of this disease. However, phenotypes only cover the clinically relevant aspects of the disease, but do not address the relationship between the disease and its etiology and pathophysiology. This led to the development of the term "endotypes" which links key pathogenic mechanisms with asthma phenotypes, and ultimately leads to better selection of treatment resulting in improved response. Although the exact pathogenesis of asthma is still under investigation, targeted-therapy based on asthma phenotypes and endotypes has shown some success, and the future appears promising for patients suffering from severe asthma since treatment is being tailored according to individual biology. We review in this manuscript the best evidence and updates currently available in the classification and treatment recommendations for severe asthma.

Mepolizumab’s (Anti-Interleukin-5) Role in Severe Asthma: A Literature Review

“…organized the phenotypes of people with severe asthma. 5,7 These characteristics are divided into two groups: the inflammatory and clinical phenotypes.…”

“…Severe asthma with recurring exacerbations, asthma and severe neutrophilic asthma (neutrophil value >61%), as illustrated in Table 1. 5,7 Table 1. Characteristics of the severe asthma phenotype 7 phenotype.…”

“…The group of people with difficult-to-treat asthma makes up 17% of the population, while the group of people with severe asthma makes up 7.7% of the 17%. 1,7 Chronic airway inflammation and lung tissue remodeling characterize the diverse illness known as severe asthma, which has a range of clinical symptoms and therapeutic responses. 5,8,9 Mepolizumab significantly reduced the frequency of exacerbations, the use of oral corticosteroids (OCS), hospitalization, and emergency room visits in Shabbir et al's study of the drug as an adjunctive therapy for severe eosinophilic asthma when compared to placebo.…”