Rapid advances in biologic therapy have truly revolutionised the management of severe asthma in the past decade. The efficacy of these drugs has been undeniably demonstrated in randomised controlled trials (RCTs) and real-world studies, with reassuring safety data. Many patients with severe asthma have had their lives transformed after starting a biologic, which is an extremely gratifying result. Questions remain, however, about the optimal long-term management of patients with severe asthma treated with biologics. The Global Initiative for Asthma (GINA) recommends assessing response to biologic therapy after 4 months of treatment and to consider switching to a different biologic in patients with partial or no clinical response [1, 2]. In patients with good clinical response and controlled asthma, stepwise reduction in background controller therapy is recommended, starting with maintenance oral corticosteroids (OCS).

过去十年中，生物疗法的快速进步真正彻底改变了严重哮喘的治疗。这些药物的功效已在随机对照试验 (RCT) 和现实世界研究中得到无可否认的证明，并具有令人放心的安全数据。许多严重哮喘患者在开始使用生物制剂后生活发生了改变，这是一个非常令人欣喜的结果。然而，对于接受生物制剂治疗的严重哮喘患者的最佳长期治疗仍存在疑问。全球哮喘倡议 (GINA) 建议在治疗 4 个月后评估生物疗法的反应，并考虑对部分或无临床反应的患者改用不同的生物制剂 [1, 2]。对于临床反应良好且哮喘得到控制的患者，建议从维持性口服皮质类固醇 (OCS) 开始逐步减少背景控制治疗。