What are biologics for asthma?
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.
Biologic therapy for asthma medications are administered once or twice a month.
Biologic therapy for asthma are medicines modified to target certain molecules in humans.
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.
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.Find an Asthma Specialist
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.
This medication, also known as Xolair®, blocks an antibody that causes an allergic reaction. It’s used for moderate-to-severe persistent asthma and allergies triggered by allergens such as pet dander and dust mites. This medication is approved for asthma patients as young as 6 years old.
Side Effects of Omalizumab
Severe allergic reactions are possible but rare with this medication. The most common side effects of omalizumab include:
- A reaction at the injection site
- Achy joints
- Achy muscles
Also known as Nucala®, this medication treats eosinophilic asthma. Mepolizumab works by lowering the blood’s eosinophils count. It is approved for patients at least 12 years old or older.
Side Effects of Mepolizumab
Severe allergic reactions are possible but rare with this medication. The most common side effects of mepolizumab include:
- A reaction at the injection site
- Back pain
This medication, known as Cinqair®, also treats eosinophilic asthma by reducing the number of eosinophils in the blood. This treatment is for asthma patients aged 18 and older.
Side Effects of Reslizumab
Severe allergic reactions are possible but rare with this medication. The most common side effects of reslizumab include:
- Achy muscles
- A sore throat
Known as Fasenra®, benralizumab is another medication that helps treat poorly controlled eosinophilic asthma by lowering the amount of eosinophils in the blood. It is approved for patients at least 12 years old or older.
Side Effects of Benralizumab
Severe allergic reactions are possible but rare with this medication. The most common side effects of benralizumab include:
- A sore throat
This medication, also known as Dupixent®, also helps treat eosinophilic asthma. It is approved for patients at least 12 years old or older.
Side Effects of Dupilumab
Severe allergic reactions are possible but rare with this medication. The most common side effects of dupilumab include:
- A reaction at the injection site
- A sore throat
- An elevated eosinophil level
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
How biologics are administered at AllerVe Health clinics
Rather than taking your care to another location who doesn’t know you, we can handle everything within our office, who you already trust. Our providers assess each patient before prescribing biologic treatment for asthma.
First, your doctor will consider the medications you’re currently taking to ensure you’re administering the medications as prescribed. They will also ask about any potentially new triggers that could be making your asthma worse. Next, your medical provider may ask you to undergo testing such as Pulmonary Function Tests (PFTs), which measure how well your lungs are working.
Once you have been identified as a candidate for Biologics, we will immediately begin working directly with your insurance on your behalf.
Once your insurance approves the use of Biologics, we will schedule your first injection. From then on, depending on the particular drug you need, you will come to our office every 4-8 weeks for follow up injections. Injections can even happen during your follow up appointments, saving you from having to go to multiple appointments or multiple doctors offices.
The benefit to doing biologics with your AllerVie Health physician is that rather than going to an infusion center to receive these injections, which are usually multi-hour appointments, we can handle everything while you’re already at your appointment in our office.
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
- 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:
- Low blood pressure
- Dizziness or fainting
- Facial swelling including the mouth and tongue
Will I still need to take my inhalers?
Yes, you should continue using your inhaler and other asthma medications as prescribed when taking biologics for asthma. Keep in mind that it can take weeks or months for the biologic therapy for asthma to work, depending on the treatment. Therefore, you might end up needing these medications should your asthma symptoms increase. Your medical provider will let you know if you need to decrease or adjust the dose of these medications.
Are biologics for asthma safe?
Yes, biologics for asthma are considered safe. Before you start treatment, be aware that biologic drugs, depending on the drug and dose, could cause side effects such as: headaches, fatigue, injection site irritation, cold-like symptoms, and a sinus infection. In rare cases, these medications can cause anaphylaxis, a severe allergic reaction. Your doctor will monitor you for signs and symptoms of anaphylaxis.
Do I have to take biologics forever?
There’s no set time frame for how long you’ll have to take biologics. At this time, it’s recommended that patients take prescribed biologic treatment for at least four months under the supervision of a medical professional. It can take several weeks to months to see results from biologic therapy for asthma. Your doctor will work with you to determine how long you should take biologics for asthma.
Are biologics worth taking?
Biologics for asthma can be helpful for patients with moderate-to-severe asthma — especially if traditional asthma medications are not easing your asthma symptoms. Asthma biologics are a cutting-edge development in the asthma treatment space. Several clinical trials have shown that biologic therapies for asthma have been effective in reducing the exacerbation of asthma and the need to use corticosteroids, according to the National Library of Medicine. However, whether or not a patient decides to use biologics for the treatment of asthma is a personal decision that patients should make under the guidance of their medical provider.
Can your body reject biologics?
Your body can fight off biologics, making them less effective and safe. Biologics can trigger an immune response in your body that forms antidrug antibodies (ADAs), which see biologic therapy as a threat. Whether or not this will happen varies among biologic therapies. In a 2023 study of the five biologics approved for asthma in the U.S., less than 3% of study participants developed ADAs throughout the study’s follow-up period. “The incidence was highest in the benralizumab group and lowest in the omalizumab group,” according to the study published in the Journal of Allergy and Clinical Immunology.
Do asthma biologics make you immunocompromised?
Currently, there is no evidence to suggest that biologics for asthma make you immunocompromised concerning infectious diseases such as COVID-19. Biologic therapies do not impact the part of the immune system that wards off infection. Biologics and the effects of COVID-19 on asthma patients are two topics that researchers and medical professionals are continuing to study.
Are biologics covered by health insurance?
Working with insurance can be complicated, that’s why our clinics will work with your health insurance on your behalf. Some health insurance companies will pay a percentage of the cost for biologic therapies for asthma, with the patient paying the remaining balance. How much a patient pays will depend on several factors, such as:
- The insurance company
- What the insurance policy covers
- Whether or not the patient’s out-of-pocket deductible has been met
Usually, your medical provider’s office will contact your insurance company before prescribing the medication. Check with the pharmaceutical companies that make these biologic treatments for asthma. Often, these companies have programs that help patients pay for these cutting-edge treatments.
What is the cost of biologic treatment?
Biologic therapy for asthma is more expensive than traditional, widely-used controller medications for asthma. In fact, the final cost can total thousands of dollars, depending on the biologic and dose. Biologic therapies are more expensive because they are difficult to make. While most traditional medications are created by mixing chemicals, biologics are made using material from living organisms.