A case series of dual biologics therapy for severe asthma

Treatment with monoclonal antibodies (mAb) targeting IgE, IL-5, and IL-4/IL-13 pathways has become the standard strategy to manage severe asthmatics refractory to conventional therapies. Biologics are effective in improving symptom control, exacerbation rates, and oral corticosteroid (OCS) dependence.1 However, a subset of patients show suboptimal response, manifesting as persistent OCS use and functional decline.2 Given the complex relationship between cytokines, immune cells, and structural cells in driving the pathophysiology of asthma, it is conceivable that targeting a single pathway may be insufficient for optimal asthma control.