New treatments for severe asthma may include biologics, surgical techniques, and leukotriene modifiers, among others. Researchers are still searching for new drugs to prevent and relieve asthma.

Asthma is a disease that causes the airways to swell up and tighten, making it hard to catch your breath. Symptoms include:

Symptoms can be more severe in some people and less severe in others. You might only have symptoms at certain times, like when you exercise. You could also have frequent asthma attacks that affect your quality of life.

Asthma isn’t curable, but it is manageable. Today’s treatments are more effective than ever at preventing asthma attacks and stopping symptoms if they do start.

Still, 17 percent of asthma cases are labeled as difficult to treat. This means they don’t respond to standard treatments, like inhaled corticosteroids.

For those with severe symptoms, a new generation of therapies and other treatments on the horizon might finally offer some relief.

Asthma treatment involves a three-part strategy:

  • using long-term management medications to prevent symptoms before they start
  • using quick-relief medications to stop acute asthma attacks
  • avoiding triggers to reduce the number of attacks

To manage severe asthma, you may need to take higher doses of medications or use more than one medication. You and your doctor can create an asthma management plan to personalize your treatment strategy based on your symptoms and disease severity.

The main treatment for severe asthma is taking long-term management medications that help prevent asthma symptoms. These include:

  • inhaled corticosteroids
  • inhaled long-acting beta-agonists
  • inhaled long-acting anticholinergics
  • leukotriene modifiers
  • cromolyn sodium (Intal)
  • theophylline (Theochron)
  • oral corticosteroids

You can then take quick-relief medications to relieve symptoms when you have an asthma attack. These include:

  • inhaled short-acting beta-agonists
  • inhaled short-acting anticholinergics
  • a combination of both of the above

A few newer treatments have made severe asthma easier to manage.


Biologic drugs work with your immune system to treat asthma. They block the activity of immune system chemicals that make your airways swell up. These drugs can help prevent asthma attacks and make the attacks you do have more mild.

Six monoclonal antibodies are currently approved to treat severe asthma:

  • reslizumab (Cinqair)
  • mepolizumab (Nucala)
  • omalizumab (Xolair)
  • benralizumab (Fasenra)
  • dupilumab (Dupixent)
  • tezepelumab (Tezspire)

Omalizumab treats severe asthma that’s triggered by allergies. Mepolizumab, reslizumab, and benralizumab treat severe asthma caused by a type of white blood cell called an eosinophil (eosinophilic asthma). You take these drugs by injection or an IV inserted into a vein.

Dupliumb is an add-on maintenance treatment currently approved for patients between the ages of 6 to 11. This treatment is given through injection.

Tezepelumab is used as an add-on maintenance treatment for patients 12 and older. It’s the first treatment not limited by the type of severe asthma. This treatment is also given through injection.

Tiotropium (Spiriva)

This inhaled medication has been used to treat chronic obstructive pulmonary disease (COPD) for more than a decade. In 2015, the FDA also approved it for the treatment of asthma.

A 2016 review found that tiotropium improves asthma management when added to high doses of inhaled corticosteroids and short-acting beta-agonists.

Leukotriene modifiers

One group of asthma drugs works by blocking the action of leukotriene. This chemical tightens and narrows your airways during an allergy-induced asthma attack.

Three leukotriene modifiers are approved to treat asthma:

  • montelukast (Singulair)
  • zafirlukast (Accolate)
  • zileuton (Zyflo)

You take these medications by mouth to prevent or treat asthma attacks.

Bronchial thermoplasty

Bronchial thermoplasty is a surgical technique used for severe asthma that hasn’t improved with other treatments.

During this technique, radiofrequency energy is applied to the airway. The heat that’s generated destroys some of the smooth muscle lining the airway. This prevents the muscle from constricting and narrowing the opening.

Bronchial thermoplasty is delivered in three sessions, each given 3 weeks apart. Even though it isn’t a cure for asthma, 2018 research shows it does reduce symptoms.

Researchers are still searching for new drugs that will be able to prevent and relieve asthma symptoms. One drug that generated potential is Fevipiprant.

While in development, this experimental drug reduced symptoms and airway inflammation in people with allergic asthma that inhaled corticosteroids could not, according to 2016 research.

However, the company Novaris, which was developing Fevipiprant, decided to cease further development due to trials showing that the drug didn’t do much better than a placebo.

Some research is focusing on how combining multiple existing medications can aid in managing asthma attacks.

A 2021 review suggests adding long-acting muscarinic antagonist to inhaled corticosteroids and long-acting β2-agonists could lead to fewer severe asthma attacks and modest improvement in asthma management.

Other studies are investigating the factors that play a role in asthma development, such as calcium-sensing receptor (CaSR). Identifying the triggers that set off asthma symptoms could one day enable researchers to stop those processes and prevent asthma before it starts.

Asthma is a disease that causes the airways to swell up and tighten, making it hard to breathe. There is currently no cure for asthma, but there are treatment options that can help reduce its symptoms.

If you have severe symptoms, you may require multiple treatment options for your asthma. Talk with your doctor about which options are best for you.