The FDA has approved depemokimab (Exdensur – GSK), a long-acting interleukin-5 (IL-5) antagonist, for add-on maintenance treatment of severe asthma characterized by an eosinophilic phenotype in patients ≥12 years old. Depemokimab is the fourth IL-5-directed treatment to be approved in the US for this indication; the IL-5 antagonists mepolizumab (Nucala) and reslizumab (Cinqair) and the IL-5 receptor alpha antagonist benralizumab (Fasenra) were approved earlier.

The goal of asthma treatment is to control symptoms, prevent exacerbations, and maintain normal lung function. Management of acute exacerbations in the emergency department is not discussed here.

The main goals of treatment of chronic obstructive pulmonary disease (COPD) are to relieve symptoms, reduce the frequency and severity of exacerbations, prevent disease progression, and reduce mortality. GOLD (Global Initiative for Chronic Obstructive Lung Disease) guidelines for treatment of COPD were updated recently. Treatment of acute exacerbations is not discussed here. Drugs available for treatment of COPD are listed in Tables 1 and 3.

Tezepelumab-ekko (Tezspire – AstraZeneca/Amgen), a subcutaneously administered thymic stromal lymphopoietin (TSLP) blocker, has been approved by the FDA for add-on maintenance treatment of severe asthma in patients ≥12 years old. It is the first TSLP blocker to become available in the US and the first biologic drug to be approved for treatment of severe asthma without phenotypic or biomarker limitations.