Abstract
Current therapy for asthma with inhaled corticosteroids and long-acting inhaled β2-agonists is highly effective, safe, and relatively inexpensive, but many patients
remain poorly controlled. Most advances have been through improving these drug classes
and a major developmental hurdle is to improve existing drug classes. Major unmet
needs include better treatment of severe asthma (which has some similarity to chronic
obstructive pulmonary disease), as well as curative therapies for mild to moderate
asthma that do not result in the return of symptoms when the treatment is stopped.
Several new treatments are in development, but many are specific, targeting a single
mediator or receptor, and are unlikely to have a major clinical impact, although they
may be effective in specific asthma phenotypes (endotypes). Drugs with more widespread
effects, such as kinase inhibitors, may be more effective but have a greater risk
of side effects so inhaled delivery may be needed. Several new treatments target the
underlying allergic/immune process and would treat concomitant allergic diseases.
Improved immunotherapy approaches have the potential for disease modification, although
prospects for a cure are currently remote.
Keywords
asthma - inflammation - corticosteroids - bronchodilator - cytokine - chemokine -
IgE - kinase
