Overview
Severe type 2 airway inflammation of the lower respiratory tract includes conditions such as asthma and eosinophilic chronic obstructive pulmonary disease (COPD) 1. These disorders are characterized by persistent inflammation that often remains uncontrolled despite regular maintenance therapy 1.Diagnosis
Clinical Assessment: Identification of severe airway disease in patients who remain symptomatic or uncontrolled despite standard regular treatment 1.
Phenotyping: Evaluation for type 2 inflammatory markers, specifically targeting eosinophilic profiles in conditions like COPD and asthma 1.Management
Biologics: Use of injectable medications that target specific molecules relevant to the type 2 inflammatory cascade 1.
Indications: Reserved for patients with severe asthma or eosinophilic COPD who are uncontrolled on standard-of-care regimens 1.
Treatment Goals: Therapy is directed at improving symptoms, enhancing quality of life, and reducing the frequency of exacerbations requiring hospitalization 1.Special Populations
Adults: Current evidence and guidance focus on the management of adult patients with severe airway disease 1.Key Recommendations
Biologics should be used in adult patients with severe type 2 lower airway diseases (e.g., asthma, eosinophilic COPD) who remain uncontrolled despite regular treatment 1. (Evidence: Strong)
In patients with severe lower airway disease, biologics are recommended to reduce exacerbations and the need for hospitalization 1. (Evidence: Strong)References
1 Fokkens WJ, Backer V, Lund VJ, Barnes PJ, Bernal-Sprekelsen M, Bjermer L et al.. Pocket guide: biologics in upper and lower airways in adults. Rhinology 2025. link