The newest treatments for severe asthma: Biologics
Biological medications, often called biologics, are a relatively new type of medication for asthma. Compared to most medications that are made using chemical reactions, biologics are made using living systems (like bacterial/viral cells, plant or animal cells). An example of a common biologic is the flu vaccine, which is usually grown in chicken eggs.
Biologics are designed to inhibit certain components of the immune system that trigger inflammation—and it is inflammation in the airways that causes a lot of your asthma symptoms.
Biologics for treating asthma now include Xolair® (available since 2005), Cinqair™, Nucala™ and Fasenra®.
According to The Lung Association’s 2018 Asthma Survey, sixty-three per cent of asthma patients have never discussed biologics as an option with their healthcare provider[i]. This indicates that greater awareness of respiratory biologics is needed, by both healthcare providers and patients!
Medication class: IgE-neutralizing antibody (Anti-IgE)
What it is: Xolair® is given to you by an injection (shot) from a healthcare professional every two to four weeks. You will still need to continue using all of your asthma medication as prescribed by your healthcare provider.
Who it’s for: Xolair® may be prescribed to reduce the symptoms of asthma due to allergic triggers for individuals aged 12 and older.
How it works: Immunoglobulin E (IgE) is a type of protein that our bodies naturally make in small amounts. In allergic asthma the IgE increases abnormally, causing swelling and tightening of the airways. Anti-IgE therapy reduces the ability of IgE to cause symptoms. Possible side effects should be explained to you by your healthcare provider.
Medication class: Interleukin-5 (IL-5) inhibitor
What it is: Cinqair™ is given to you by intravenous infusion (IV) by a healthcare professional every four weeks. Nucala™ is given to you by subcutaneous injection (just-under-the-skin shot) by a healthcare professional every four weeks. You will still need to continue using all of your asthma medication as prescribed by your healthcare provider.
Who it’s for: IL-5 inhibitors are sometimes prescribed for the maintenance treatment of severe asthma in patients aged 18 years or older. IL-5 inhibitors are only effective for people who have a certain level of eosinophil, a type of white blood cell in your blood. Your healthcare provider will check your blood eosinophil level before prescribing the medication.
How it works: IL-5 inhibitors may be added if your asthma is not under control despite using medium to high doses of inhaled corticosteroids plus another controller medication. Possible side effects should be explained to you by your healthcare provider.
Medication class: Anti-eosinophil (anti-interleukin-5 receptor alpha monoclonal antibody)
What it is: Fasenra® is given to you as an injection just under the skin (subcutaneously) by a healthcare professional. The injection is given every 4 weeks for the first 3 injections, and then every 8 weeks thereafter. You will still need to continue using all of your asthma medication as prescribed by your healthcare provider.
Who it’s for: Fasenra® is used for the maintenance treatment of adult patients with severe eosinophilic asthma, whose asthma is not controlled with their current asthma medicines. Severe eosinophilic asthma is a type of asthma where patients have increased eosinophils in the blood or lungs. You will still need to continue using all of your asthma medication as prescribed by your healthcare provider.
How it works: Eosinophils are a type of white blood cell that are associated with inflammation of the airways that can cause your asthma to get worse or can increase the number of asthma attacks. Fasenra works by reducing the number of eosinophils in the blood and lungs and helps reduce the number of asthma attacks that you experience. Possible side effects should be explained to you by your healthcare provider.
[i] Leger. (2018). Lung Association of Canada, 2018 Asthma Survey