Evidence for phenotype-driven treatment in asthmatic patients

Curr Opin Allergy Clin Immunol. 2011 Aug;11(4):381-5. doi: 10.1097/ACI.0b013e328348a8f9.

Abstract

Purpose of review: Asthma is a complex inflammatory disease and current therapy remains inadequate in many sufferers. There is phenotypic heterogeneity in its clinical expression as a consequence of gene-environment interactions and heterogeneity in response to therapy. This review summarizes the current state of knowledge on phenotype-driven treatment of asthma.

Recent findings: Evidence is accumulating that even standard therapies such as inhaled corticosteroids benefit some groups of asthmatic patients more than others. Macrolide antibiotics and antifungal agents are examples of drugs that have established indications outside the field of airways disease but which may benefit a subset of patients with asthma. Finally, new and expensive biological therapies for asthma are emerging that may be highly efficacious, but only for a selected group of patients.

Summary: The emergence of novel therapies, in particular highly specific treatments, bring the promise of improving healthcare in asthma but present the challenge of choosing the right therapy for the right patient. Phenotype-driven treatment of asthma is emerging as a potential reality and will pave the way for personalized healthcare.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / therapeutic use
  • Adrenergic beta-2 Receptor Agonists / therapeutic use
  • Anti-Asthmatic Agents / classification
  • Anti-Asthmatic Agents / therapeutic use*
  • Anti-Bacterial Agents / therapeutic use
  • Antibodies, Monoclonal / therapeutic use
  • Antifungal Agents / therapeutic use
  • Asthma / classification
  • Asthma / drug therapy*
  • Cell Count
  • Cholinergic Antagonists / therapeutic use
  • Eosinophils
  • Evidence-Based Medicine
  • Humans
  • Leukotriene Antagonists / therapeutic use
  • Patient Selection
  • Phenotype*
  • Precision Medicine*
  • Randomized Controlled Trials as Topic
  • Sputum / cytology
  • Therapies, Investigational
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Adrenergic beta-2 Receptor Agonists
  • Anti-Asthmatic Agents
  • Anti-Bacterial Agents
  • Antibodies, Monoclonal
  • Antifungal Agents
  • Cholinergic Antagonists
  • Leukotriene Antagonists