New therapies for asthma: is there any progress?

Current therapy for asthma with inhaled corticosteroids and long-acting inhaled beta(2)-agonists is highly effective, safe and relatively inexpensive, but for many patients, their disease remains poorly controlled. Most advances in asthma therapy have occurred through improving these drug classes, and a major developmental hurdle is to improve existing drug classes. The major unmet needs include better treatment of severe asthma, and curative therapies for mild to moderate asthma. Many new treatments are specific, targeting a single mediator or receptor, and are unlikely to have a major clinical effect, although they might be effective in specific asthma phenotypes. Drugs with more widespread effects, such as kinase inhibitors, might be more effective but have a greater risk of side effects. New treatments targeting the underlying allergic/immune process would treat concomitant allergic diseases. Improved immunotherapy approaches have the prospect of disease modification, although prospects for a cure are currently remote. The most promising therapeutic developments for asthma are discussed in this review.