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I'm Considering Biologics For My Asthma, What Can I Expect?

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I’m considering starting a biologic for my asthma. What can I expect? I’ve tried different medicines and treatments without any success.

If your asthma has not been well controlled, you may be a candidate for a biologic medication to treat moderate-to-severe persistent asthma. Asthma biologic therapies are unique. They target a specific antibody, molecule, or cell involved in asthma. Make sure you check with your asthma specialist to confirm that you are a candidate for them. Specific criteria include:

  • Age
  • Poor symptom control of asthma on other common treatments (e.g., daily inhaled controller medications, quick-relief inhalers)
  • Certain lab test (e.g., blood levels of eosinophils or IgE)

There are several things you could expect when starting a biologic therapy:

  1. The main benefit is a decrease in asthma episodes. This includes emergency room visits, hospitalizations, and the need for oral steroids. Other benefits include:
    • Reduced asthma symptoms
    • Reduced dosage of other controller medications
    • Less missed school and work days
    • Improved quality of life
    • Improved lung function
  2. There are currently five approved biologics for asthma (with others in development). Your doctor will get screening tests. This will help them decide which therapy would be the best to treat your asthma. It can include blood work or allergy skin testing.
  3. Many of these biologics are administered in a doctor’s office. This is done as either a subcutaneous injection or infusion. Some of these products can be administered at home with an autoinjector.
  4. The frequency of administration of each biologic is different. It can range from every two to every eight weeks.
  5. Studies have found these treatments to be safe. The side effects should be reviewed with your doctor. Common ones include soreness at the injection site, headache, sore throat, and fatigue. There is a very rare risk of anaphylaxis with some of them.
  6. There are no set recommendations on how long you will need to be on a biologic when your asthma is under good control. Work with your doctor to make this decision.
  7. Compared to other controller medications for asthma, biologics are much more expensive. They can cost up to thousands of dollars per year or more. Check with your insurance company to make sure the medication is covered before starting treatment.

Discuss this with your allergy and asthma specialist to make the most informed medical decision.

Asthma, Medicines, Treatment
Answered by

John M. James, MD, is a board-certified allergist. He is also President of Food Allergy Consulting and Education Services, LLC. He has worked as a medical specialist in the field of allergy, asthma, and immunology for over 30 years. Dr. James received his bachelor’s degree from the University of Arkansas and his Doctor of Medicine degree from the University of Tennessee. He is board certified by the American Board of Allergy and Immunology.

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