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For most asthma sufferers, asthma can be adequately managed with inhaler therapy. Some patients, however, have more severe asthma episodes, more frequent symptoms, and more progressive disease. These asthma cases usually cannot be managed with inhaler therapy alone. Thankfully, biologic therapies exist, offering an additional option for severe asthma sufferers. These medications, referred to as “biologics”, target different biological pathways, allowing them to treat more serious diseases. They are available via the intravenous (IV) or subcutaneous route, meaning they are administered through a vein. This article will discuss available biologic therapies for severe persistent asthma.

Cinqair (reslizumab)

Use: Cinqair is a medication used to treat eosinophilic asthma. Eosinophilic asthma is a severe form of asthma characterized by increased white blood cell levels known as eosinophils, which are an important component of the body’s immune system.

Administration: Cinqair is administered intravenously at a dose of 3 mg/kg once every four weeks, with each infusion lasting between twenty to fifty minutes. It is suggested that patients undergo at least four months of treatment before determining treatment effectiveness.

Side effects: Cinqair can cause the following common side effects:

  • Sore throat
  • Increased creatine phosphokinase levels (an enzyme in the body)
  • Muscle pain
  • Severe allergic reactions (rare)

Fasenra (benralizumab)

Use: Fasenra is indicated for eosinophilic asthma, as it helps asthma symptoms by decreasing eosinophil levels in the blood.

Administration: Fasenra is given subcutaneously as a shot under the skin. It is administered at a dose of 30 mg every four weeks for the initial three doses and then once every eight weeks thereafter. It is suggested that patients undergo at least four months of treatment before determining treatment effectiveness.

Side effects: Fasenra can cause the following common side effects:

  • Headache
  • Sore throat
  • Fever
  • Severe allergic reactions (rare)

Nucala (mepolizumab)

Use: Nucala is indicated for eosinophilic asthma, as it helps asthma symptoms by decreasing eosinophil levels in the blood.

Administration: Nucala is given subcutaneously as a shot under the skin. It is administered at a dose of 100 mg every four weeks. It is suggested that patients undergo at least three to six months of treatment before determining treatment effectiveness.

Side effects: Nucala can cause the following common side effects:

  • Headache
  • Injection site reaction (e.g., burning, pain, itching, or swelling at the injection site)
  • Back pain
  • Joint discomfort
  • Fatigue
  • Allergic reactions
  • Weakness

Dupixent (dupilumab)

Use: Dupixent is indicated for eosinophilic asthma, as it helps asthma symptoms by decreasing levels of inflammatory cells in the body.

Administration: Dupixent is given subcutaneously as a shot under the skin. It is administered at a dose of 400 mg once (given as two 200 mg injections) and then 200 mg every other week thereafter. It can also be given at a dose of 600 mg once (given as two 300 mg injections) and then 300 mg every other week thereafter. It is suggested that patients undergo at least four months of treatment before determining treatment effectiveness.

Side effects: Dupixent can cause the following common side effects:

  • Sore throat
  • Injection site reaction (e.g., pain and redness)
  • Increased eosinophil levels
  • Severe allergic reactions (rare)

Contact us if you are interested in learning how you can start your treatments with at home infusion therapy and bring more flexibility into your life.


References

  1. Biologic therapy for severe asthma. (n.d.). Cleveland Clinic. Retrieved May 17, 2022, from https://my.clevelandclinic.org/health/treatments/17711-biologic-therapy-for-severe-asthma
  2. Lexicomp. (n.d.). Retrieved May 17, 2022, from https://online.lexi.com/lco/action/home