| Abstract [eng] |
Severe asthma is diagnosed in up to 10 % of patients with asthma, with the eosinophilic phenotype being the most common form. Although severe asthma affects a relatively small proportion of patients, this group carries the greatest disease burden – frequent, life-threatening exacerbations and a substantially impaired quality of life. Over the past decade, the asthma management paradigm has fundamentally shifted toward a precision medicine approach. The integration of biological therapy into severe asthma treatment algorithms has opened new opportunities for individualised care; however, challenges remain in clinical practice regarding the selection of the most appropriate biological agent and the decision to switch therapy in cases of inadequate response. This thesis reviews, based on the current literature, the pathogenesis of severe asthma, factors complicating disease control, and the possibilities of biological therapy. A clinical case of severe eosinophilic asthma is also presented and analysed. The literature search was performed using PubMed, Google Scholar, and ClinicalKey databases. Publications no older than 10 years and the most recent international and national severe asthma guidelines were selected. The analysed clinical case of a patient with severe eosinophilic asthma highlighted the importance of biological therapy in the management of severe asthma. In a patient whose asthma was inadequately controlled with mepolizumab, switching to benralizumab resulted in a good clinical response – a reduction in symptom intensity and reliever medication use, along with an improved quality of life. This case illustrates that an inadequate response to the initial biological agent is observed in up to 25 % of patients, making a switch of the biological agent an important component of the treatment strategy. At present, there is a lack of unified international guidelines to help clinicians combine and switch biological agents; therefore, further long-term observational studies are needed. |
