Table 9– Potential phenotype-targeted therapies in severe asthma#
CharacteristicAssociationsSpecifically targeted treatments
Severe allergic asthmaBlood and sputum eosinophilsAnti-IgE (adults and children)
High serum IgEAnti-IL-4/IL-13
High FeNOAnti-IL-4 receptor
Eosinophilic asthmaBlood and sputum eosinophilsAnti-IL-5
Recurrent exacerbationsAnti-IL-4/IL-13
High FeNOAnti-IL-4 receptor
Neutrophilic asthmaCorticosteroid insensitivityAnti-IL-8
Bacterial infectionsCXCR2 antagonists
Anti-LTB4 (adults and children)
Macrolides (adults and children)
Chronic airflow obstructionAirway wall remodelling as increased airway wall thicknessAnti-IL-13
Bronchial thermoplasty
Recurrent exacerbationsSputum eosinophils in sputumAnti-IL5
Reduced response to ICS and/or OCSAnti-IgE (adults and children)
Corticosteroid insensitivityIncreased neutrophils in sputump38 MAPK inhibitors
Theophylline (adults and children)
Macrolides (adults and children)
  • FeNO: exhaled nitric oxide fraction; IL: interleukin; LTB4: leukotriene B4; ICS: inhaled corticosteroid; OCS: oral corticosteroid; MAPK: mitogen-activated protein kinase. #: Unless otherwise stated, these potential treatments apply to adults; : neutrophilic asthma is rare in children.