The American College of Chest Physicians (CHEST) has issued a new clinical guideline for the management of severe asthma using biologic therapies. The guideline, published in the journal CHEST, offers seven evidence-based recommendations to help specialists such as pulmonologists, allergists, and immunologists choose appropriate biologic treatments for their patients.
Severe asthma affects between 5% and 10% of all individuals diagnosed with asthma. These are patients who need high-dose inhaled corticosteroids along with another controller medication. For those whose symptoms do not improve with standard treatments, biologic agents have become a key option. However, selecting the right biologic remains challenging due to various patient-specific factors.
The new CHEST guideline reviews currently available biologics and provides recommendations tailored to different patient groups. The panel suggests that if there is no satisfactory clinical response after four to six months on a particular biologic therapy, clinicians should consider switching the patient to an alternative agent. Factors influencing this decision include whether the patient uses oral corticosteroids at baseline, how often they experience exacerbations, their asthma endotype based on biomarker data, baseline lung function measurements, and any coexisting medical conditions.
All seven recommendations from the guideline are available in detail through the CHEST journal article titled "Biologic Management in Severe Asthma for Adults: An American College of Chest Physicians Clinical Practice Guideline."
