Biological Therapies in Severe Asthma, Case Report and Literature Review.
DOI:
https://doi.org/10.61182/rnavmed.v11n2a3Keywords:
Asthma, Eosinophilia, Dupilumab, Biomarkers, Precision MedicineAbstract
Uncontrolled severe asthma represents a significant burden for healthcare systems, with patients exhibiting type 2 inflammation (high T2 endotype) being among the most challenging to manage. In recent years, biological therapies have revolutionized the approach to this condition. We present the case of a 47-year-old woman diagnosed with moderate asthma since 2017, who progressed to refractory severe T2 asthma. Despite multiple treatment regimens with bronchodilators, inhaled corticosteroids, and leukotriene receptor antagonists, she experienced frequent exacerbations, hospitalizations, and persistent symptoms.
Laboratory workup revealed elevated sputum eosinophils (15,635 UI/mL), total serum IgE, and FeNO levels, along with severe obstructive pattern on spirometry and a significant bronchodilator response. Due to lack of control with standard therapies, treatment with Dupilumab (200 mg subcutaneously every two weeks) was initiated, along with combination inhaled therapy and antihistamines. At the two-year follow-up, the patient showed marked clinical improvement, with no new exacerbations or hospitalizations, improved spirometric function (FEV1), and sustained reduction of inflammatory biomarkers.
The identification of inflammatory endotypes and the use of biomarkers enable a precision medicine approach, optimizing the management of severe asthma. This case highlights the real-world effectiveness of Dupilumab and underscores the importance of its timely and sustained implementation in appropriate patients.
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Copyright (c) 2025 Ricardo Andrés Donado-Botero, David Fernando Ortiz-Pérez, María Fernanda Ahumada-Hernández, Marianella Peréz-Rubio, Karina Margarita Ibañez-Sanchez, Isabella Alejandra Mesa-Beltrán, Valentina Porto-Eljaiek, Mateo Andrés Martínez-Eljach
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