Dr Anne Reihman: Latest Respiratory Research Lacks a Definition for “Adequate Response” in Biologics

Updated guidelines help to address which patients are most appropriate for biologic therapy, noted Anne Reihman, MD, University of Colorado, Division of Pulmonary Sciences and Critical Care Medicine.

Updated guidelines released last year from the European Respiratory Society (ERS), the American Thoracic Society (ATS), and the Global Initiative for Asthma (GINA), help to address who is most appropriate for biologic therapy, which previous guidelines did not because of a lack of data, noted Anne Reihman, MD, third-year pulmonary and critical care fellow, University of Colorado, Division of Pulmonary Sciences and Critical Care Medicine.


What do the new European Respiratory Society/American Thoracic Society guidelines address that other guidelines do not?

Last year, the ERS, ATS, and GINA all came out with updated guidelines for management of severe asthma. And these were really important because previously, the severe asthma guidelines were several years old. There wasn't a lot of data at that time about the biologic therapies, and so while they were mentioned in the previous sets of guidelines, who should be on those therapies and when they should be utilized wasn't really discussed. These updated set of guidelines really go into more detail about who is appropriate for these therapies, [and] I think provide a lot more guidance to clinicians about when they should be initiating these therapies for patients.

The guidelines do still have some limitations. One of the big ones, I think, is there still no standard definition for adequate treatment response to biologic therapy. And that's actually, I think, one of the big pitfalls in the research around biologics: Because we don't have standard criteria for defining an adequate response, we can't really define prevalence of failure of these drugs, and I think that's really limiting our research right now in this area.