The treatment approach for severe asthma has changed significantly during the past decade. Omalizumab, a monoclonal antibody against immunoglobulin E (IgE), was the first biologic agent approved in the United States and Europe for the treatment of severe asthma. In 2018, 3 additional biologic agents—all targeting interleukin-5 (IL-5) or its receptor, are also available for use.1 In addition to choosing among various inhalers and other asthma medications, clinicians now face the additional challenge of deciding which biologic agent to use first, if at all, for the treatment of severe asthma.
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