What are biologics for asthma?

Biologic therapies for asthma are relatively new medicines that help prevent moderate-to-severe asthma symptoms before they emerge by targeting antibodies, cell receptors or inflammatory molecules.

These medicines, known as “precision” or “personalized” therapy, are administered once or twice a month as either a under the skin or intravenous injection. Often, biologic therapy for asthma is for people who have severe asthma that isn’t managed by usual controller medications.

Biologics for asthma can make a big difference for people who suffer from asthma. These medications are made from cells of living organisms. The two most important characteristics of biologics are how often they’re administered and what they target in the body. Since asthma is a complex disease, results vary by patient. Currently, there are five FDA-approved biologic injections for asthma.



Medication Timing

Biologic therapy for asthma medications are administered once or twice a month.


Molecules Targeted

Biologic therapy for asthma are medicines modified to target certain molecules in humans.


In-Clinic Care

Biologics are administered on-site at our clinics, rather than you having to wait at an infusion center or another location who doesn’t know you. We can handle everything within our office, who you already trust.

Woman in a laboratory doing genomic medicine research for biologics for asthma therapies

What is a biologic?

Biologics are medications that are made from living organisms. Vaccines, allergens, and gene therapy are all examples of products that can contain biologics. Because they can be used to treat both common and rare diseases, these strong, complicated medicines are at the cutting edge of drug research.

  • Cutting-Edge: New biologics for asthma are in development.
  • Powerful: Biologic therapies treat severe asthma when common asthma medications aren’t working.

When should you consider biologics for your asthma?

Those with more severe, uncontrolled persistent asthma symptoms are good candidates for biologic therapy to treat severe asthma. Typically, biologics for asthma are recommended when conventional asthma medications are no longer effective in preventing asthma exacerbations.

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Symptoms of poorly controlled asthma

Symptoms of uncontrolled or poorly controlled asthma include:

  • Frequent daytime asthma symptoms
  • Taking oral corticosteroid several times a year
  • Quick-relief, rescue medications more than twice/week
  • Lower peak flow measurements
  • Disrupted sleep from coughing or other asthma symptoms
  • Limiting activity because of asthma

Types of asthma that benefit from biologic therapy

So far, the biologics developed for asthma help treat type 2 inflammation, an immune response pattern that plays a role in medical conditions.

Several of the available biologic therapies treat eosinophilic asthma. Also known as e-asthma or eos asthma, eosinophilic asthma is severe type of asthma that can be difficult to control with traditional asthma medications.

This condition is caused by high levels of eosinophils, a type of white blood cells, in the lung’s airways. White blood cells help our bodies fight infections, but sometimes eosinophils can overreact, causing inflammation.

Eosinophilic asthma can have allergic or non-allergic triggers. Studies suggest that about 50% of severe asthma cases are eosinophilic asthma.

Why should I treat my asthma with biologic therapy?

Properly managed asthma can increase your quality of life. Other benefits include:

  • Better lung function
  • Fewer visits to urgent care or emergency rooms
  • Less dependence on oral steroids
  • Reduced dosage of controller medications
  • Increased lung function

Biologic drugs for asthma

At the time of writing this, Summer 2023, there are five injectable FDA-approved biologics for asthma available to patients.

These biologics are: omalizumab, mepolizumab, reslizumab, benralizumab and dupilumab. Omalizumab targets antibodies that cause allergic reactions.

The other four medications — mepolizumab, reslizumab, benralizumab and dupilumab — treat eosinophilic asthma. Eosinophils, a type of white blood cells, can inflame the lungs of some asthma patients. Several other biologics are in development. Your medical provider can help determine which medication is best for your unique needs.






Doctor in a hospital evaluating if a female older patient is a candidate for biologic therapy for asthma treatment

Can I get biologic treatment for asthma?

Biologics for asthma are for patients who have persistent and/or severe asthma symptoms that have not improved with the use of more traditional asthma treatments such as inhaled corticosteroids and short-acting beta-agonists. A doctor may consider you for biologic therapy for asthma if you’re:

  • Relying on a quick-relief inhaler two times a week or more
  • Waking up at night with difficulty breathing 
  • Visiting the emergency room or urgent care more than twice a year because of asthma symptoms
  • In need of oral or injection steroids twice a year or more
  • Experiencing frequent bouts of coughing, wheezing or shortness of breath

Keep in mind: Before prescribing a biologic treatment for asthma, your doctor may:

  • Ensure that you’re taking your medication properly and as prescribed
  • Note any new triggers that could be making your asthma worse
  • Check to make sure another condition or medication isn’t provoking your asthma symptoms

Do biologic therapies for asthma work?

Most patients taking biologics for asthma will experience controlled asthma symptoms after several weeks to a few months.

How fast they see results depends on the patient and the type of biologic prescribed.

How quickly do biologics work?

How fast a biologic therapy for asthma works depends on several factors.

  • Omalizumab (Xolair®): a few weeks to several months
  • Mepolizumab (Nucala®): within 48 hours; may take up to four weeks for both asthma and eosinophilic granulomatosis with polyangiitis (EGPA)
  • Reslizumab (®): within four weeks when added to other asthma treatments
  • Benralizumab (Fasenra®): starts decreasing eosinophils in blood within 24 hours; reduces asthma exacerbations after four weeks
  • Dupilumab (Dupixent®): as quickly as two weeks after starting the treatment

How long do you take biologics for asthma?

Most guidelines suggest taking the biologic for at least four months. With that said, there’s no set time frame for how long a patient should be on biologic treatment for asthma.

Keep track of your symptoms during this time frame. Your doctor will help you determine whether or not you should continue taking the biologic therapy for asthma. Here’s how often patients should take the five approved biologics for asthma:

  • Omalizumab (Xolair®): For adults and children 12 and older, this biologic is injected under the skin every two to four weeks, depending on the prescribed dose. Your medical provider may adjust the dose depending on your need and tolerance.
  • Mepolizumab (Nucala®): This biologic is injected every four weeks.
  • Reslizumab (Cinqair®): This medication is administered every four weeks by IV. Each treatment takes between 20 to 50 minutes. 
  • Benralizumab (Fasenra®): The first three doses given every four weeks. After that, the medication is administered every eight weeks.
  • Dupilumab (Dupixent®): This medication is given as a shot every two weeks. Usually, patients will get the first three doses in their doctor’s office. Patients can give themselves dupilumab at home once they know how to inject it and no adverse reactions appear.

Asthma biologics side effects

As with any medical treatment, there are potential side effects with the use of biologics for asthma. Side effects vary depending on which of the five approved biologics for asthma you are prescribed. However, the most common side effects include:

  • A sinus infection
  • Irritation at the injection site
  • Headaches
  • Fatigue/lethargy
  • Cold-like symptoms

It’s rare but biologics for asthma can sometimes cause a severe allergic reaction called anaphylaxis. Your doctor will monitor you for anaphylaxis symptoms, which include:

  • Wheezing
  • Low blood pressure
  • Dizziness or fainting
  • Itching
  • Facial swelling including the mouth and tongue


Will I still need to take my inhalers?

Are biologics for asthma safe?

Do I have to take biologics forever?

Are biologics worth taking?

Can your body reject biologics?

Do asthma biologics make you immunocompromised?

Are biologics covered by health insurance?

What is the cost of biologic treatment?