Biologics

Your health care provider may recommend treatment with biologics if you have severe asthma with symptoms that are not easily managed by control medications. Biologics reduce inflammation by targeting immune system antibodies or specific cells. Taken together with other asthma medications, biologics help people with more-severe forms of asthma gain greater symptom control.

Your provider will typically do bloodwork to decide which biologic will work best for you. Some biologics are given as a shot (injection) and some are given by a vein (intravenously).

Biologic for allergic asthma

Omalizumab (Xolair) is sometimes used to treat asthma triggered by airborne allergens. If you have allergies, your immune system identifies a harmless airborne substance — such as pollen, dust mites and pet dander — as being harmful. This substance is called an allergen.

Your immune system is how your body protects itself, so it produces immunoglobulin E (IgE) antibodies to protect against this allergen. These antibodies signal your immune system to release chemicals into your bloodstream, causing a reaction that leads to allergy and asthma symptoms. Omalizumab blocks the action of these antibodies, reducing the immune system reaction.

Omalizumab is given as an injection every 2 to 4 weeks. It isn't generally recommended for children under 12 years of age. In rare cases, this medication has triggered a life-threatening allergic reaction (anaphylaxis). In addition, the U.S. Food and Drug Administration (FDA) has issued a warning about a slightly increased risk of heart and brain blood vessel problems while taking this drug.

Anyone who gets an injection of this drug should be monitored closely by health care professionals in case of a severe reaction.

Biologics for eosinophilic asthma

A newer class of biologic drugs has been developed to target specific substances produced by certain immune system cells. For some people, certain white blood cells, called eosinophils, build up within body tissues. Eosinophils release substances, called cytokines, which cause inflammation. These biological drugs target eosinophils and cytokines, reducing their numbers within the body and lowering inflammation.

These medications include:

• Benralizumab (Fasenra)
• Dupilumab (Dupixent)
• Mepolizumab (Nucala)
• Reslizumab (Cinqair)

Biologic for either eosinophilic asthma or allergic asthma

Tezepelumab-ekko (Tezspire) is a recently FDA-approved biologic for people with severe asthma. This medication can be used to treat eosinophilic asthma or allergic asthma by reducing certain kinds of cytokines that cause inflammation.