Medicina personalizzata ed asma

The increasing knowledge about molecular biology and pathogenetic mechanisms of asthma have led to a thorough definition of different phenotypes and endotypes, particularly in severe refractory asthma. For several years we have had only omalizumab as innovative therapy to meet the needs of a specific group of patients with severe uncontrolled allergic asthma. Most recently, bronchial thermoplasty has been introduced, a promising endoscopic procedure, but with still many points to be clarified on its mechanism of action. New monoclonal antibodies are being launched for the clinical setting, particularly those targeting the IL-5 block and still others will come in the near future. This recent abundance of treatment options, sometimes partially overlapping in their effects, makes it essential to validate new biomarkers to guide the clinician in selecting the most appropriate therapy for the individual patient and possibly to define the correct duration of treatments. All this without forgetting the high direct cost of these new therapies, in order to avoid waste of valuable resources especially in the present context of socio-economic restriction.