• Tomoya Harada, Genki Inui, Miki Takata, Ryota Okazaki, Kosuke Yamaguchi, and Akira Yamasaki.
• Division of Respiratory Medicine and Rheumatology, Faculty of Medicine, Tottori University, Japan.
• Intern. Med. 2025 Jan 15.

AbstractAsthma is characterized by chronic airway inflammation as its primary pathological condition, which leads to various respiratory symptoms due to airway narrowing, with type 2 inflammation playing a central role. Asthma treatment, primarily centered on inhaled corticosteroids, aims to suppress type 2 inflammation and improve airway narrowing. However, severe asthma that cannot be controlled with high-dose inhaled corticosteroids or other asthma medications remains a clinical issue. The availability of multiple biological agents has recently improved the management of severe asthma. In addition, the concept of clinical remission has emerged as a treatment goal, further clarifying the objectives of asthma management. However, despite these advancements, the treatment of severe asthma driven primarily by non-type 2 inflammation remains a major challenge, and new biologics are currently being developed to address this issue.

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