Advances in pathophysiological understanding and the elucidation of a type 2 inflammatory signature with interleukins 4, 5 and 13 at its center have led to the development of targeted antibody therapies that are now approved for the treatment of severe asthma. In suitable patients, these medications reduce asthma exacerbations and the necessity for oral corticosteroids, improve asthma control, quality of life and lung function. A proportion of patients with severe asthma may even achieve remission under ongoing biologic therapy. Type-2 inflammatory comorbidities are frequent in patients with severe asthma, sharing overlapping pathophysiology and may similarly respond to biologic treatment. Here, we give an overview of the six biologic therapies currently approved for severe asthma and review randomized clinical trials and real-life studies in asthma and other type-2 inflammatory diseases. We also discuss selection of biologics according to licensing criteria, asthma phenotype and biomarkers, monitoring of treatment response and proceedings in case of insufficient outcome under therapy.

病理生理学认识的进步以及以白细胞介素 4、5 和 13 为中心的 2 型炎症特征的阐明导致了靶向抗体疗法的开发，这些疗法现已被批准用于治疗严重哮喘。在合适的患者中，这些药物可以减少哮喘发作和口服皮质类固醇的必要性，改善哮喘控制、生活质量和肺功能。部分严重哮喘患者在持续的生物治疗下甚至可能获得缓解。2 型炎症合并症在严重哮喘患者中很常见，具有重叠的病理生理学特征，并且可能对生物治疗有类似的反应。在这里，我们概述了目前批准用于治疗严重哮喘的六种生物疗法，并回顾了哮喘和其他 2 型炎症性疾病的随机临床试验和现实研究。我们还讨论了根据许可标准、哮喘表型和生物标志物选择生物制剂、监测治疗反应以及在治疗结果不足的情况下的程序。