Infrequent Treatments for Occupational Asthma: Immunotherapy and Biological Therapy

Opinion Statement

Occupational asthma is an important social, health, and economic burden in our society, but its treatment options have not been yet sufficiently explored. Drug therapies do not differ much from ordinary asthma treatments, and avoidance is the main managing option for this condition. However, other therapeutic options like immunotherapy and biological therapies have not been used as in other asthma and rhinitis etiologies. Occupational asthma has different pathomechanisms depending of its triggers, but in immunological IgE-dependent asthma, these therapies can be fairly efficient. Not many immunotherapy studies have been carried out lately on this topic, and its reproducibility might be its biggest disadvantage. Maybe the main existing limitation is the lack of standardized extracts in order to perform this treatment. With no proper extracts, this treatment cannot be implemented, and its tolerance is going to differ depending on the extract used in each specific case. On the other hand, biological treatments are a promising option in the management of severe occupational asthma. Not many studies have been conducted so far in occupational allergy. Nevertheless, these biological treatments are upcoming and evolving therapies, so we expect further studies in a close future, including recently approved therapeutic options such as mepolizumab in eosinophilic refractory asthma. These new treatment possibilities should enhance their use and empower them also in the occupational field.

The aim of this study is to focus the spotlight in these asthma treatments to encourage the study of its efficacy in occupational asthma, try to optimize the treatment options for this disorder, and bring these infrequent treatments out of the ostracism where they are found nowadays.

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