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Evidence for phenotype-driven treatment in asthmatic patients

Gonem, Sherif; Desai, Dhananjay; Siddiqui, Salman; Brightling, Christopher C.E.

Current Opinion in Allergy and Clinical Immunology: August 2011 - Volume 11 - Issue 4 - p 381–385
doi: 10.1097/ACI.0b013e328348a8f9
Pharmacotherapy and evidence based medicine: Edited by David A. Khan and Enrico Compalati

Purpose of review Asthma is a complex inflammatory disease and current therapy remains inadequate in many sufferers. There is phenotypic heterogeneity in its clinical expression as a consequence of gene–environment interactions and heterogeneity in response to therapy. This review summarizes the current state of knowledge on phenotype-driven treatment of asthma.

Recent findings Evidence is accumulating that even standard therapies such as inhaled corticosteroids benefit some groups of asthmatic patients more than others. Macrolide antibiotics and antifungal agents are examples of drugs that have established indications outside the field of airways disease but which may benefit a subset of patients with asthma. Finally, new and expensive biological therapies for asthma are emerging that may be highly efficacious, but only for a selected group of patients.

Summary The emergence of novel therapies, in particular highly specific treatments, bring the promise of improving healthcare in asthma but present the challenge of choosing the right therapy for the right patient. Phenotype-driven treatment of asthma is emerging as a potential reality and will pave the way for personalized healthcare.

Department of Infection, Immunity and Inflammation, Institute for Lung Health, University of Leicester, Leicester, UK

Correspondence to Professor Christopher C.E. Brightling, Institute for Lung Health, Clinical Sciences Wing, University Hospitals of Leicester, Leicester LE3 9QP, UK Tel: +44 116 258 3998; fax: +44 116 258 3950; e-mail:

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.