Pneumology - Reviews
2 July 2025
Early Access
Potential novel role of asthma biologics as rescue therapy in the intensive care unit for life-threatening asthma exacerbations: a systematic review
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Severe asthma exacerbations have high morbidity and mortality. The management can be challenging, and the optimal strategy for patients admitted to the intensive care unit (ICU) with life-threatening and near-fatal asthma has not been fully defined. An interesting area of research is represented by the rescue or compassionate use of biological drugs when all treatments fail, including advanced interventions such as extracorporeal membrane oxygenation. This systematic review analyzes the cases described in the literature and discusses characteristics, treatments, and outcomes of patients who received asthma-approved monoclonal antibodies as rescue therapy following admission to the ICU due to near-fatal asthma exacerbations or status asthmaticus refractory to conventional treatments. A total of 14 studies (13 case reports and 1 case series) were included according to the prespecified inclusion and exclusion criteria. Various monoclonal antibodies were administered, most commonly benralizumab and omalizumab. Treatment was generally initiated within the first week of ICU admission, with nearly half of the patients receiving therapy within 5 days. Further research, including randomized controlled trials, is required to assess if this therapeutic option impacts ICU outcomes, which specific biologics could be used, and their eventual optimal timing and dosage.
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How to Cite
“Potential Novel Role of Asthma Biologics As Rescue Therapy in the Intensive Care Unit for Life-Threatening Asthma Exacerbations: A Systematic Review”. 2025. Monaldi Archives for Chest Disease, July. https://doi.org/10.4081/monaldi.2025.3319.
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