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June 4, 2026Open Access

A Narrative Review of Biologic Therapies for Type 2 Inflammation in Severe Asthma and Eosinophilic Chronic Obstructive Pulmonary Disease (COPD): Mechanisms, Efficacy, and Safety

Key Points

This review explores the mechanisms, efficacy, and safety of biologic therapies for type 2 inflammation in severe asthma and eosinophilic chronic obstructive pulmonary disease.
Reviewed multiple studies on biologic therapies targeting various inflammatory pathways.
Analyzed data on efficacy, safety, and optimal patient selection strategies.
Examined approved biologics including omalizumab, mepolizumab, dupilumab, and others.
Biologics significantly reduce exacerbation rates in severe asthma and eosinophilic COPD.
Improvement in lung function and reduction in corticosteroid use were noted across diverse populations.
Quality of life enhancements were consistently reported in patients receiving these therapies.

Abstract

Severe asthma affects a minority of patients but accounts for disproportionate morbidity, mortality, and healthcare costs. The development of targeted biologic therapies has revolutionized treatment, offering precision medicine approaches based on underlying inflammatory endotypes. Currently approved biologics target immunoglobulin E (omalizumab), interleukin (IL)-5 or its receptor (mepolizumab, reslizumab, depemokimab, and benralizumab), IL-4 receptor α (dupilumab), and thymic stromal lymphopoietin (tezepelumab). These agents have demonstrated substantial reductions in exacerbation rates, improved lung function, corticosteroid-sparing effects, and enhanced quality of life across diverse patient populations. This review examines the mechanisms of action, clinical efficacy, safety profiles, and optimal patient selection strategies for biologic therapies in severe asthma and eosinophilic COPD.

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