How Monoclonal Antibodies Are Changing the Treatment Landscape

For decades, steroids have been the cornerstone of asthma management. Effective- yes, but not without cost. Long-term use of systemic corticosteroids like prednisone can lead to serious side effects: weight gain, osteoporosis, hypertension, glucose intolerance, and increased infection risk.

But what if we could control asthma without chronic steroid dependence?
That’s exactly where monoclonal antibodies (mAbs) are stepping in, offering new hope for patients with moderate-to-severe asthma.

The Science Behind It: Precision Over Suppression

Asthma is not one disease, it’s a spectrum of inflammatory pathways, with eosinophils and IgE often playing key roles in airway inflammation.
Monoclonal antibodies are designed to target these specific pathways, delivering precision where steroids provide broad, often excessive suppression.

Key biologics currently approved for asthma management include:

• Reslizumab and Mepolizumab – target IL-5 to reduce eosinophilic inflammation.
• Benralizumab – induces apoptosis of eosinophils via IL-5 receptor α blockade.
• Dupilumab – blocks IL-4 and IL-13 signaling, reducing both eosinophilic and allergic responses.
• Tezepelumab – inhibits thymic stromal lymphopoietin (TSLP), an upstream driver of multiple inflammatory cascades.

Administered monthly or bi-monthly, these agents have demonstrated significant improvement in asthma control, reduction in exacerbation frequency, and better quality of life, often with fewer systemic side effects.

Steroid-Sparing, Not Steroid-Replacing

The term “steroid-sparing” doesn’t mean steroids are obsolete.
Instead, it means patients can maintain symptom control with lower doses or reduced dependence, minimizing long-term complications.

For individuals who have struggled with chronic prednisone use, monoclonal antibodies can represent a clinically meaningful shift, improving adherence, confidence, and overall health outcomes.

Clinical and Real-World Impact

Patients who respond well to monoclonal antibody therapy often report:

• Fewer hospitalizations and emergency visits
• Improved lung function (FEV₁)
• Reduced oral corticosteroid use
• Enhanced symptom control and day-to-day function

These outcomes highlights that, the future of asthma management lies in immune modulation, not just inflammation suppression.

The Takeaway

Monoclonal antibodies is one of the most promising advancements in respiratory medicine today.
While cost and accessibility remain challenges, their steroid-sparing potential could reshape asthma care, especially for those with difficult-to-treat or eosinophilic asthma.

In short, we may be moving toward a future where precision therapy replaces chronic steroid use, improving both patient outcomes and quality of life.