Terapias monoclonais na asma grave: a mirada experta da enfermaría respiratoria

The introduction of monoclonal antibodies has marked a major shift in the management of severe asthma, enabling precision medicine targeted at the inflammatory mechanisms underlying the disease. In this context, respiratory nursing plays a key role in ensuring safety, treatment adherence and meaningful clinical outcomes. Before initiating biologic therapy, respiratory nurses assess essential aspects such as adherence to baseline treatment, inhaler technique, symptom control and modifiable risk factors. This assessment helps identify whether poor disease control is related to inadequate adherence or incorrect inhaler use, thereby preventing inappropriate therapeutic decisions. Available monoclonal antibodies allow treatment to be tailored to each person’s inflammatory phenotype, including allergic T2, eosinophilic T2 and non-T2 profiles. Nurses are involved in drug storage, preparation, administration and post-dose monitoring, particularly for early detection of hypersensitivity reactions or anaphylaxis. Home self-administration using pre-filled pens or syringes represents a significant advance, provided that the person or caregiver receives appropriate training. Nurses lead this educational process, supervise the first administrations, correct errors and build confidence. Clinical follow-up is essential, as therapeutic response may take several months. At each visit, exacerbation frequency, rescue medication use, quality of life, adverse effects, control tests and adherence to baseline inhaled therapy are assessed. In conclusion, monoclonal therapies have revolutionised severe asthma care, but their true impact depends on continuous, educational and humanised nursing intervention, capable of turning pharmacological innovation into real and sustainable health outcomes.