asthma with chronic obstructive pulmonary disease

Asthma clinical trials are increasingly stratified by phenotype — Type 2 high (eosinophilic, IgE-mediated) versus Type 2 low (neutrophilic or paucigranulocytic) — because this distinction predicts response to biologic therapies. The anti-IL-5, anti-IL-4/13, and anti-TSLP antibody classes have revolutionized severe asthma management, and trials now aim to achieve full remission rather than just symptom control.

Trials evaluate dupilumab combinations, tezepelumab (anti-TSLP) in Type 2 low asthma, itepekimab, biologic step-down strategies, and oral corticosteroid-sparing approaches. Digital inhalers with adherence monitoring are being validated as outcomes tools. Bronchial thermoplasty for severe non-biologic-responsive patients remains an active surgical comparator.