Difficult Asthma: Unmet Needs and Future Directions

Despite advances in asthma management, many patients continue to suffer from uncontrolled asthma. In the United States alone, ten patients per day die from asthma, and for several decades, the prevalence and economic burden of asthma have been increasing. This has placed greater emphasis on the need to develop new therapeutic approaches to control asthma that are also cost-effective. Evidence indicates that asthma is a heterogeneous disease; therefore, a “one-size-fits-all” approach may not be effective in all patients. The availability of new anti-IL5 biologics has made a significant progress in treating severe eosinophilic asthma (type 2); however, no such therapies have been developed to target non-eosinophilic asthma (non-type 2). In addition, a subset of these type 2 asthma patients continues to have exacerbations despite treatments targeting IL5. Therefore, there is a significant unmet need for identifying different asthma phenotypes and developing precision medicine therapies targeting each phenotype to improve patient outcomes. One such approach could be based on an “omics” diagnostic panel to stratify patients’ molecular phenotypes and consider targeted treatments based on these phenotypes. Additional approaches to optimize asthma control include developing novel therapeutics, new technologies to aid in asthma management, and more effective and safer drug delivery systems.