Despite the administration of appropriate treatment, a high number of patients 
with asthma remain uncontrolled. This suggests the need for alternative 
treatments that are effective, safe and selective for the established asthma 
phenotypes, especially in patients with uncontrolled severe asthma. The most 
promising options among the new asthma treatments in development are biological 
therapies, particularly those monoclonal antibodies directed at selective 
targets. It should be noted that the different drugs, and especially the new 
biologics, act on very specific pathogenic pathways. Therefore, determination of 
the individual profile of predominant pathophysiological alterations of each 
patient will be increasingly important for prescribing the most appropriate 
treatment in each case. The treatment of severe allergic asthma with anti-IgE 
monoclonal antibody (omalizumab) has been shown to be effective in a large 
number of patients, and new anti-IgE antibodies with improved pharmacodynamic 
properties are being investigated. Among developing therapies, biologics 
designed to block certain pro-inflammatory cytokines, such as IL-5 (mepolizumab) 
and IL-13 (lebrikizumab), have a greater chance of being used in the clinic. 
Perhaps blocking more than one cytokine pathway (such as IL-4 and IL-13 with 
dulipumab) might confer increased efficacy of treatment, along with acceptable 
safety. Stratification of asthma based on the predominant pathogenic mechanisms 
of each patient (phenoendotypes) is slowly, but probably irreversibly, emerging 
as a tailored medical approach to asthma, and is becoming a key factor in the 
development of drugs for this complex respiratory syndrome.