New Treatment Approaches and Biomarkers in Severe Asthma: An Updated Review

Authors : Murat Ali Çiçekler, İrfan Çınar

Pages : 65-83

Doi:10.71051/jnlm.1835995

View : 51 | Download : 99

Publication Date : 2026-01-02

Article Type : Review Paper

Abstract :This study aims to evaluate the effectiveness of biological treatments in severe asthma and to reveal the role of basic biomarkers used in disease management in the clinical decision-making process. A systematic review was conducted using the keywords \\\"severe asthma,\\\" \\\"biomarker,\\\" and \\\"biologic therapy\\\" in PubMed, Web of Science, Cochrane, and Google Scholar databases between 2015 and 2024. Type 2 high and Type 2 low asthma subtypes were evaluated based on the biomarkers used (blood eosinophil count, FeNO, periostin, and IgE), as well as the biological treatments applied (omalizumab, mepolizumab, benralizumab, dupilumab, and tezepelumab), and their corresponding clinical outcomes. Literature analysis has shown that biomarkers are strong predictors of treatment response in patients with Type 2 asthma. In particular, high eosinophil counts and increased FeNO levels were associated with a favorable response to biologic agents targeting IL-5 and IL-4/IL-13. In patients with Type 2 low asthma, the response to existing biologic therapies is limited, and alternative approaches such as alarmin-targeted therapies (tezepelumab) and azithromycin have emerged. While biologic therapies have made significant progress in the management of severe asthma, a phenotype- and biomarker-based approach is critical for accurate treatment selection. While biomarkers are effective in assessing treatment response in Type 2 high asthma, research is needed to identify new targets for Type 2 low asthma. The development of personalized treatment strategies will form the basis of future asthma management.
Keywords : Şiddetli Astım, Biyobelirteç, Biyolojik Tedavi, Tip 2 Yüksek Astım, Tip 2 Düşük Astım, Kişiselleştirilmiş Tıp.

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