Asthma is a chronic condition that affects a person’s airways. When a person comes into contact with a trigger, they can experience symptoms such as wheezing and tightness in the chest that can make it hard to breathe. One treatment option for people with severe asthma is the use of biologics.

Asthma affects around 7.8% of people in the United States. It is a long-term condition that causes the inside walls of the airways, or bronchial tubes, to become inflamed and swollen.

When a person with asthma experiences exposure to certain triggers, they can have an asthma attack. Allergens, irritants, viruses, exercise, and emotional stress can all trigger an attack.

A person often takes long-term medication to prevent asthma attacks. They may also use a quick-relief medication to treat their asthma symptoms when they arise.

These approaches work for most people, but 5–10% of people with asthma have severe asthma or asthma that is difficult to control. This means that they may experience symptoms more regularly.

Biologics are a newer group of drugs that people can use to treat more severe asthma. Read on to learn about what biologics are, the types of biologics available, how doctors administer them, and their potential side effects.

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Biologics are a type of medication that mimics molecules that live in organisms or cells.

These medications often mimic certain proteins that can turn off specific parts of a person’s immune system. This makes them a good treatment option for a number of immunodeficiency disorders.

Biologic therapies are able to target certain inflammatory pathways involved in causing asthma symptoms to occur. By doing this, they can block the action of specific molecules to help prevent or reduce inflammation. This prevents or reduces symptoms.

Studies have shown that targeted biologic therapies can reduce asthma exacerbations, improve lung function, reduce a person’s use of oral corticosteroids, and improve overall quality of life.

If a person has asthma that is difficult to control, they may require treatment with biologics.

A person may have asthma that is difficult to control if:

  • they experience frequent coughing, wheezing, or shortness of breath
  • they wake up at night with difficulty breathing
  • they require a fast-acting reliever medication like albuterol several times throughout the week
  • they regularly require treatment at the hospital
  • they require oral steroids to treat exacerbations

According to the American Academy of Allergy Asthma and Immunology (AAAAI), the Food and Drug Administration (FDA) has approved five biologics for the treatment of asthma. They are:

Xolair

Xolair targets a type of allergy antibody known as immunoglobulin E (IgE). The body produces IgE when a person has an allergy.

When a person comes into contact with certain allergens such as dust, pollen, or animal fur, their IgE antibodies bind to receptors on immune cells. This causes an allergic reaction through the release of inflammatory mediators, like histamine and tryptase, which can trigger asthma symptoms such as coughing, shortness of breath, and wheezing.

Xolair blocks these antibodies, which lowers a person’s IgE activity, preventing the allergic reaction and the triggering of asthma symptoms.

Medical professionals can also use Xolair to treat long-lasting hives.

Nucala, Cinqair, and Fasenra

Nucala, Cinqair, and Fasenra target disease-fighting white blood cells that are involved in allergic inflammation. These cells are called eosinophils.

Eosinophils are the predominant cells that play a role in the inflammatory response in the lungs of asthmatics.

If a person has a large number of eosinophils, they may have eosinophilic asthma. In this case, their eosinophils can cause inflammation in the airways and respiratory system, producing asthma symptoms.

Nucala, Cinqair, and Fasenra can bind to these eosinophils to prevent them from triggering an immune response. By doing this, these medications can reduce a person’s asthma symptoms.

Medical professionals also use Nucala to treat eosinophilic granulomatosis with polyangiitis, formerly known as Churg Strauss Syndrome. This is a rare small vessel vasculitis, or inflammation of blood vessels, strongly associated with asthma.

Dupixent

Dupixent targets a receptor for two of the molecules that drive allergic inflammation in asthma. The two molecules are proteins called interleukin-4 and interleukin-13.

Dupixent blocks these two proteins from triggering the immune response that causes asthma symptoms to arise.

Medical professionals also use Dupixent to treat eczema and chronic rhinosinusitis with nasal polyposis.

Doctors may administer biologics in their offices via injection or IV infusion. In some cases, the doctor may observe a person for between 30 minutes and 2 hours after they receive the treatment.

However, there are now multiple biologic options available for at-home use, including Nucala, Fasenra, and Dupixent. People can even transition to at-home administration of Xolair after initial dosing in a supervised medical setting.

The frequency of administration for these biologics varies. A person may need a dose every 2–8 weeks.

According to the AAAAI, studies have shown biologics to be a very safe treatment.

Common side effects of biologic treatment include:

Xolair carries a very small risk of anaphylaxis. This is the name for a severe allergic reaction.

If this does occur, a doctor will likely prescribe an epinephrine autoinjector, which a person can use to give themselves a dose of epinephrine. Epinephrine is a hormone that can block the progression of the allergic response in an emergency.

Before a person takes Nucala, their doctor may ask about their chickenpox and shingles vaccination status. This is because some participants in clinical trials of Nucala experienced infection with the virus that causes these infections.

Asthma is a lifelong condition that causes inflammation and swelling in a person’s airways. If a person with asthma comes into contact with a trigger like dust or pollen, they may experience an asthma attack. Symptoms include wheezing and tightness in the chest that can make it hard to breathe.

If a person’s asthma is severe or difficult to control, they may require treatment with biologics, which are drugs that mimic molecules that live in organisms or cells. Biologics often contain proteins that target certain immune system cells and prevent them from triggering an allergic response, reducing asthma symptoms.

The FDA has approved five biologics for treating asthma. These drugs are very safe and only cause minor side effects such as headaches, pain at the injection site, and fatigue. In some rare instances, Xolair can cause a person to have a serious allergic reaction.