When to use biologics, plus JAK/STATs for asthma

April 23, 2018

I hope you have had a great April so far and are looking forward to summer. I trust all of you have received your April issue of the Annals of Allergy, Asthma and Immunology. Just in case you might have missed them, I want to point out two more articles that are “must reads” in this month’s issue.

The first is a CME review by Tara Vinyette Saco, MD, Amber Pepper, MD, and Thomas B. Casale, MD, FACAAI, that attacks the question of “when I have decided that a particular patient needs a biologic, which biologic do I choose and when?” The authors review various allergic disease phenotypes, biomarkers that are available and the approval status for these agents for specific clinical indications (important in the insurance approval process). This is a timely piece that will be useful for the practicing clinician trying to decide the best options for the patient needing more than conventional therapy for their allergic diseases.

The other article that is important for you to read is by Michael D. Howell, MD, PhD, Carolyn Fitzsimons, MBA, and Paul A. Smith, PhD. It discusses using small target molecules such as JAK/STATs for treatment of asthma and other allergic diseases. JAK/STATs are examples of transcription pathways responsible for getting signals to the nucleus to activate inflammatory cells active in the pathophysiology of various allergic diseases. As we learn more about the molecular biology of allergic and nonallergic inflammation in diseases such as asthma, common pathways are being discovered that may broaden therapies to include more difficult to treat cases such as those with “Th2 Low” asthma. This article is clearly written and referenced and can serve as a strong introduction into the topic of JAK/STAT antagonisms as therapeutic tools. This is certain to become more common in the years to come.

I am grateful for the feedback we receive, from comments about our cover to content requests to critiques of published articles. All of this is useful for our editorial team as we continue to make our journal better for you, our readers. Comments are welcome. Look for your May issue of the Annals in your mailbox and online in the next weeks.

Gailen D. Marshall, Jr., MD PhD FACAAI