Biologic Therapies in Severe Asthma and Eosinophilic Granulomatosis with Polyangiitis: Targeted Therapy and Personalized Care

Biologic agents have revolutionized severe asthma management by supporting biomarker‑driven approaches. Five monoclonal antibodies-omalizumab, mepolizumab, reslizumab, benralizumab, and dupilumab-are in widespread use, while the recently approved tezepelumab, an anti-thymic stromal lymphopoietin, broadens therapeutic possibilities to encompass the type 2 inflammation‑low phenotype. Although biologics have become more accessible, clinicians frequently encounter difficulties in choosing the most appropriate initial biologic therapy. This review describes real‑world cases that demonstrate phenotype‑guided selection of biologics for individuals with asthma or eosinophilic granulomatosis with polyangiitis. Additionally, current advances in biologic therapies are examined regarding their capacity to improve both accessibility and clinical efficacy. Moving forward, the integration of emerging evidence with patient-specific factors could further promote disease modification in the management of severe asthma.