If you have asthma, you probably keep a blue rescue inhaler close by, just in case. For years, that inhaler was the main way people treated asthma, and for many, it still is. But two things changed the picture in the last few years. Doctors found that using a rescue inhaler by itself actually makes a serious attack more likely. And for the roughly 2 million Americans with severe asthma, new medicines arrived that target the exact type of swelling causing their disease. The newest one only needs to be given twice a year.
Nearly 28 million Americans have asthma, about 1 in 12 people. This article covers what treatment looks like today, why about 10 people still die from asthma every day even though experts say it's almost always preventable, what researchers are testing right now, and how clinical trials fit in. If you're caring for a child, our guide to asthma care for kids and teens goes deeper into that.
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What asthma treatment includes today
The two kinds of inhaler. Relievers (usually albuterol) open up your airways within minutes when you have symptoms. Controllers, mostly inhaled steroids, calm the swelling that causes attacks in the first place. The biggest change in recent guidelines: using a reliever by itself, with no anti inflammatory medicine, is no longer recommended for anyone with asthma, because it's linked to more serious attacks. Many people now use one inhaler that combines a low dose steroid with a long acting reliever, taken both every day and whenever needed.
Step up, step down. Doctors adjust your treatment in steps, from a low dose steroid inhaler at step 1 up to high dose combinations at step 4. About 5 to 10 percent of people reach step 5, severe asthma, where inhalers alone aren't enough anymore. At that point, options include long acting bronchodilators, a pill called montelukast, and, more and more often, biologics.
Biologics: seven approved, and counting. These are injectable medicines, and each one blocks one specific signal in your immune system. Omalizumab (Xolair) was first, approved in 2003 for allergic asthma. Then came medicines aimed at eosinophils, the inflammatory cells behind about half of severe asthma cases: mepolizumab (Nucala), reslizumab (Cinqair), and benralizumab (Fasenra). Dupilumab (Dupixent) blocks two signals at once and also treats eczema and chronic sinusitis, which often show up alongside asthma. Tezepelumab (Tezspire), approved in 2021, works earlier in the process than all the others and helps even people without high eosinophil counts. And in December 2025, the FDA approved depemokimab (Exdensur), the first biologic that only needs to be given twice a year. In its two Phase 3 trials, it cut asthma attacks by 58 and 48 percent, and cut attacks bad enough to need a hospital or ER visit by 72 percent.
A blood test decides who gets what. Most biologics only help people with a specific kind of inflammation called type 2, which doctors measure with a simple eosinophil blood test. That's why a trial that seems like a perfect fit might still need a blood test result before you're accepted, and why that same test now guides everyday care for severe asthma too.
What researchers are studying now
Treating the attack itself. Biologics can prevent attacks, but no one had tested giving one during an actual emergency. A trial testing rademikibart given by IV during an acute asthma or COPD attack is asking whether one dose in the ER can shorten the attack and help stop the next one. If it works, it could change what happens when you show up to the emergency room mid-attack.
New medicines for mild and moderate asthma. Almost all biologic research focuses on severe asthma, but most people with asthma actually have the milder kind. A study of CDX-622 in mild to moderate asthma is one of the few testing a new biologic in that much bigger group. And a placebo controlled study of brenipatide in adults with asthma is testing yet another new medicine still in development.
Personalizing care where most people actually get it. Most people with asthma are treated by their family doctor, not a specialist. The Individualizing Treatment for Asthma in Primary Care study is testing whether a more structured approach can cut down on attacks in everyday care, and a pharmacogenomics study is looking at whether your genes can predict which biologic will work best for you, which could end months of trial and error.
The air you breathe at home. Not every study tests a drug. The AIRVAC study is testing whether better home ventilation and air cleaners can improve asthma control, and the Airports, Air Quality, and Asthma study is testing real air cleaners against sham ones in homes of children who live near airports, to see if it helps protect their lungs from aircraft pollution. Neither trial requires changing your medicine, and both often enroll children.
Why asthma research takes time
The attack counting problem. In most asthma drug trials, the main thing being measured is how many attacks someone has over a year, and attacks come and go unevenly and change with the seasons. That means trials have to run a full year and enroll hundreds of people just to see a real difference, which is part of why every biologic took years to get approved.
The phenotype problem. Biologics work really well for people with the right type of inflammation, and not at all for others. Trials have to turn away many volunteers whose blood tests don't match what the drug targets, which slows down recruiting, and it leaves the roughly half of severe asthma that isn't eosinophilic with fewer treatment options. Finding something for that group is still one of the field's biggest open problems.
The mild asthma gap. Companies focus their research on severe asthma because that's where biologics get approved. That means most people with asthma, who actually have the mild or moderate kind, get studied far less, even though their attacks add up to most of the ER visits.
The representation problem. Black Americans are more than twice as likely to die from asthma as white Americans, and Puerto Rican Americans have the highest asthma rate of any group, yet both are underrepresented in trials. Studies done in the neighborhoods most affected, and trials that make diverse enrollment a stated goal, are part of the answer. Here's why diversity in clinical trials matters so much.
Common myths about asthma
"You only need your inhaler when you feel symptoms."
The most dangerous myth on this list. Using a rescue inhaler by itself, with no controller, is linked to more serious attacks, and it's no longer recommended for anyone with asthma. Controllers work by stopping the inflammation before it turns into an attack, which means you take them even on days you feel fine.
"Asthma is a childhood disease you outgrow."
Some kids do get better as they grow up, but asthma can actually start at any age, and asthma that starts in adulthood tends to stick around. Adults are also six times more likely than children to die from it.
"People with asthma should avoid exercise."
It's the opposite. Exercise is recommended, and plenty of elite athletes have asthma. The key is keeping your asthma under control and, for some people, using a reliever before working out.
"Asthma is not serious anymore."
About 3,300 Americans died from asthma in 2024, roughly 10 people every day, and almost all of those deaths were preventable. That gap, between what treatment can already do and who actually gets it, is part of why trials matter.
Asthma severity levels, and what care usually looks like
Doctors describe asthma by which treatment step is needed to keep it under control, from 1 through 5. Steps 1 and 2 (mild) usually mean a low dose steroid inhaler, often paired with a reliever. Steps 3 and 4 (moderate) add a long acting bronchodilator and a higher dose. Step 5 (severe) means high dose inhalers aren't enough on their own, and a biologic or other add on is considered, usually guided by a blood eosinophil test. This describes usual practice, not a recommendation. Your plan belongs to you and your doctor.
For trials, severity is usually right in the name: study titles say "mild to moderate" or "severe" up front, and biologic trials often add "eosinophilic." Your inhaler routine, how many attacks you've had this year, and your last eosinophil result are enough to filter through studies in minutes.
How to find an asthma clinical trial
AllClinicalTrials.com lists asthma studies recruiting across the US, everything from severe asthma biologics to primary care and home environment research. Two examples recruiting right now: the Individualizing Treatment for Asthma in Primary Care study, which tests a more structured way to cut down on asthma attacks in everyday care, and a study of the new medicine CDX-622 in adults with mild to moderate asthma.
The application takes about 5 minutes. You'll answer questions about your inhalers, how many attacks you've had in the past year, and any biologic you're already taking, and if a study near you looks like a match, the research team reaches out to you. Nothing is decided until you go through informed consent, and you can stop taking part at any point. Three things to have ready: your current inhalers, how many attacks needing steroids or an ER visit you've had this year, and your most recent eosinophil count or breathing test result, if you have them.
Common questions
What is the best treatment for asthma? For most people, a daily inhaled steroid, often combined with a reliever in one inhaler, controls asthma well. For severe asthma, biologics matched to your type of inflammation are the strongest option. The best treatment is whichever one stops your attacks using the least medicine, and that depends on how severe your asthma is and what type of inflammation is driving it.
What is the newest treatment for asthma? Depemokimab (Exdensur), approved by the FDA in December 2025 for severe eosinophilic asthma in people 12 and older. It's the first asthma biologic that only needs to be given twice a year, and in trials it cut attacks by about half and cut hospital or ER visits by 72 percent.
Can asthma be cured? Not yet. Asthma can be controlled well enough that symptoms rarely show up, and some children see it fade as they get older, but the underlying airway sensitivity usually stays. Research right now is focused on people whose asthma stays uncontrolled even with treatment.
Do asthma trials use a placebo? Usually yes, in biologic trials, but the placebo is added on top of your regular inhalers, which you keep using the whole time. No one is taken off their controller medicine. Environment and primary care studies often compare two approaches to each other instead of using a placebo at all.
See asthma clinical trials recruiting now
Browse open studies, filter by location, and apply in about 5 minutes: Asthma Clinical Trials