BOX 1.

Future Areas of Research with Regards to Biologic Therapies in Patients with Asthma and Comorbid Obesity.

Questions for future research
Do the cellular and metabolic functions of airway cells differ between lean patients with asthma and asthma patients with obesity?
Which significant pathways should be targeted by biologics to reach asthma control in patients with obesity? Can serum levels of inflammatory biomarkers predict response to biologic therapy in asthma patients with obesity?
What current biologic treatment is best for patients with asthma and obesity?
What is the average biologic therapy withdrawal time for patients with asthma and obesity? Are the relapse rates significant after withdrawal for biologics in lean patients with asthma versus patients with asthma and obesity?
How does the efficacy of biological therapies change through weight loss and gain during treatment?
How does the efficacy of biological therapies change through weight loss with bariatric surgery? How does the efficacy of biological therapies change through pharmacological weight loss (ex: Orlistat)?
Does gender play a role in the efficacy of biologics in patients with asthma and obesity?
Is there a difference in the efficacy of biologics in asthma patients with obesity based on age of onset of asthma or body composition of obesity?
Is standard or weight-based dosing most effective for asthma control in patients with obesity?
Does the mechanism of delivery of the biologic drug affect the bioavailability and clinical symptoms? If so, which delivery method is the best? Does increasing the needle size for injections in patients with obesity increase the effectiveness of the biologic drugs?
Is there a super-responder and/or non-responder population within asthma patients with obesity prescribed biological therapies?