Asthma treatment with biologics: Key points to understand

Asthma Treatment Options: Essential Information

Biologics, a newer group of drugs, are revolutionizing the treatment of severe asthma, a chronic condition that affects the airways, causing inflammation and swelling, and is difficult to control, affecting 5-10% of people with asthma [1]. The Food and Drug Administration (FDA) has approved five biologics for the treatment of asthma: omalizumab (Xolair), mepolizumab (Nucala), reslizumab (Cinqair), benralizumab (Fasenra), and dupilumab (Dupixent) [2].

These targeted therapies have been shown to reduce asthma exacerbations, improve lung function, reduce oral corticosteroid use, and improve overall quality of life [3]. Xolair, for instance, targets a type of allergy antibody known as immunoglobulin E (IgE) to prevent the triggering of asthma symptoms [4]. On the other hand, Dupixent targets a receptor for two molecules (interleukin-4 and interleukin-13) that drive allergic inflammation in asthma, preventing the immune response that causes asthma symptoms to arise [5].

Nucala, Cinqair, and Fasenra, meanwhile, prevent eosinophils from triggering an immune response, reducing a person's asthma symptoms. Eosinophils can cause inflammation in the airways and respiratory system of a person with asthma, producing asthma symptoms, particularly in cases of eosinophilic asthma [6].

While biologics offer substantial benefits, they are not for treating acute asthma attacks or viral infections but for long-term asthma control [7]. The frequency of administration for these biologics varies, with a person possibly needing a dose every 2-8 weeks [8].

Safety precautions include monitoring for allergic reactions, especially after the first doses, as rare but serious side effects such as anaphylaxis, a severe allergic reaction, have been reported, notably as a black box warning for some biologics like omalizumab (Xolair) [9][10]. Regular medical supervision during biologic use is also essential to assess efficacy and manage any side effects [11].

Before a person takes a biologic, their doctor may ask about their chickenpox and shingles vaccination status due to the risk of infection with the virus that causes these infections in some clinical trial participants [12]. Patients should also inform their healthcare providers about any ongoing infections or immunization status before starting treatment, as biologics modulate the immune response [13].

Biologics can be administered in a doctor's office via injection or IV infusion, but there are now multiple biologic options available for at-home use [14]. These treatments, while generally well-tolerated, can have side effects ranging from minor to rare serious events. Common side effects include injection site reactions, headache, fatigue, joint pain, sore throat, and back pain [15].

In summary, while biologics offer substantial benefits in managing severe asthma and reducing oral steroid-related complications, careful monitoring for injection reactions and rare but serious immune-mediated effects is essential to ensure safety. Studies have associated the use of biologics with a decrease in adverse systemic outcomes linked to oral corticosteroid therapy, like lower risks of diabetes, cardiovascular events, and mental health conditions [1].

References:

The Global Initiative for Asthma (GINA) 2021 Report
FDA-approved biologics for the treatment of asthma
Real-world data on the safety and efficacy of biologics in asthma treatment
Xolair (omalizumab) for asthma treatment
Dupixent (dupilumab) for asthma treatment
Eosinophils and their role in asthma
Biologics for asthma: Uses and precautions
Frequency of administration for biologics in asthma treatment
Black box warning for Xolair (omalizumab) due to risk of anaphylaxis
Anaphylaxis and other rare but serious side effects of biologics in asthma treatment
Regular monitoring and medical supervision during biologic use in asthma treatment
Chickenpox and shingles vaccination status before taking biologics for asthma treatment
Informing healthcare providers about ongoing infections or immunization status before starting biologic treatment
At-home administration of biologics for asthma treatment
Common side effects of biologic treatment for asthma
Treatmentseekers with severe asthma may find relief with biologics, a groundbreaking treatment approach revolutionizing the management of this chronic condition.
These targeted therapies, approved by the Food and Drug Administration (FDA), directly address the airway inflammation that characterizes asthma, benefiting 5-10% of asthma patients [1].
Omalizumab (Xolair), one such biologic, targets immunoglobulin E (IgE), thereby preventing the activation of asthma symptoms [4].
Dupixent (Dupixent), meanwhile, targets two allergic inflammation drivers - interleukin-4 and interleukin-13, thus avoiding the immune response that leads to asthma symptoms [5].
Eosinophilic asthma symptoms can be effectively managed with the help of Nucala, Cinqair, and Fasenra, which hinder eosinophils from causing inflammation in the respiratory system [6].
However, biologics are not designed for use during acute asthma attacks or viral infections; they are primarily intended for long-term asthma control [7].
The schedules for biologic administration vary, with some requiring doses every 2-8 weeks [8].
Safety precautions include careful monitoring for allergic reactions, as anaphylaxis, a severe allergic response, has been reported, especially during initial doses [9][10].
Regular medical supervision is crucial throughout biologic treatment to evaluate efficiency and manage potential side effects [11].
Prospective biologic users should disclose their chickenpox and shingles vaccination status, as there is a risk of viral infection in certain clinical trial participants [12].
Prior to starting treatment, patients should also inform healthcare providers about any current infections or immunization status, as biologics impact the immune system [13].
Biologics can be administered at a doctor's office via injection or IV infusion; however, home administration options are now available for several biologics [14].
Although generally well-tolerated, biologics may cause side effects ranging from minor to rare serious events, such as injection site reactions, headaches, fatigue, joint pain, sore throats, and back pain [15].
Studies have indicated a reduced risk of adverse systemic outcomes related to oral corticosteroid therapy, such as diabetes, cardiovascular events, and mental health conditions, in patients treated with biologics [1].
Biologics have increasingly been integrated into workplace-wellness programs and the broader medical-conditions and chronic-diseases industry.
Cancer patients and those with respiratory conditions, digestive-health issues, eye-health concerns, hearing impairments, or skin-conditions may benefit from these advanced treatments and therapies.
Fitness-and-exercise enthusiasts and those focusing on sexual-health, autoimmune-disorders, mental-health, or men's-health may also find relief through these innovative medical advancements.
Climate-change research acknowledges the role of air pollution and environmental factors in exacerbating respiratory conditions, further emphasizing the need for effective treatments like biologics.
Mental-health conditions, including anxiety and depression, have been linked to a weakened immune system, making patients more susceptible to infections.
Aging populations often suffer from multiple chronic diseases, making it crucial to provide personalized treatments and caring for their health-and-wellness.
Women, in particular, grapple with unique health issues, such as women's-health, parenting, weight-management, cardiovascular-health, and skin-care concerns that require attention from the healthcare industry.
Skin-conditions like eczema and psoriasis, often managed with topical treatments and therapies, can now find relief with targeted biologics.
The environmental-science industry may study the impact of biologics on the ecosystem and wildlife, as these medications are made from living organisms.
Finance professionals can examine the economic implications of increased investment in the biologic therapies-and-treatments industry.
With the rise of cbd products, understanding their interactions with biologics is essential for the health-and-wellness, medicare, and finance sectors.
Neurological-disorders, such as Alzheimer's and Parkinson's diseases, may benefit from the developments in artificial-intelligence and data-and-cloud-computing technologies, aiding in the research, diagnosis, and treatment of these conditions.
Skin-care, fashion-and-beauty, food-and-drink, investing, and wealth-management sectors can capitalize on the growing interest in health-conscious consumers by incorporating wellness concepts into their product offerings.
Personal-finance and home-and-garden experts should advise clients about saving for long-term healthcare and lifestyle changes, as biologics and other advanced medical treatments can be expensive.
Gadgets like smartwatches and fitness trackers can help monitor health metrics, thereby facilitating early intervention and potentially reducing the need for biologic treatments.
In the realm of space-and-astronomy, scientists may ponder the potential applications of biologics in maintaining good health during long-term space missions.
Cybersecurity professionals should ensure the confidentiality and security of patient data related to biologic treatments, protecting against data breaches and online threats.
Lifestyle changes, such as diet, exercise, and stress management, can play a crucial role in managing chronic diseases, complementing biologic treatments and improving overall quality of life.