Biological therapies

[Skyblue1202]

Hi there.

Back in hospital with asthma exacerbation. I'm being referred to a specialist regarding biological therapies which might include injections each month.

Has anyone any experience of these or know more about them.

Thanks

[Js706]

Hey sorry that you’re in hospital with a flare!

There are a few different biological therapies that are available and they depend on what is driving your asthma. They’re normally given at a regular hospital appointment although some are now moving on to self-administration at home.

If you have allergic (IgE driven) asthma then the biologic available is called omalizumab (xolair). It’s given as injections under the skin either monthly or fortnightly depending on your weight and IgE levels (these can be checked with a blood test). I’ve tried xolair before and unfortunately at the time it didn’t help my asthma enough to stay on it but I didn’t have any problems with the actual drug 😊

If you have eosinophilic asthma (a type of white blood cell that can be high in some types of asthma, and can be checked on blood tests too) then there are currently 3 options available. There is mepolizumab (nucala, given every 4 weeks as an injection under the skin like xolair), benralizumab (fasenra, given first every 4 weeks, then every 8 weeks as an injection under the skin) and reslizumab (cinqaero, given in hospital as an injection into the vein every 4 weeks). I don’t have eosinophilic asthma so don’t have any experience with these but many others on here do and I’m sure they’ll be along to add their experience! But normally mepolizumab is given first and then people can move on to the other 2 if it doesn’t help.

AUK have a page with some more info on them here:

asthma.org.uk/advice/severe...

[Js706 in reply to Js706]

And to add - at the appointments you normally have to wait around after your injection. This is normally for a couple of hours after the first few to make sure you don’t react to it and then the time reduces for future ones so at my hospital you had to wait 2hrs for the first three and then it drops to 15 minutes

[Skyblue1202 in reply to Js706]

Thanks.

I know my white blood cells have gone up but they put that down to a chest infection although the doctor said she wasnt convinced.

I will anxiously wait this appointment. Prob a phone conversation this current time.

[Js706 in reply to Skyblue1202]

It’s a certain type of white blood cell (there are quite a few different ones) and they all go up in response to different things.

The one that goes up in chest infections is different to eosinophils.

[twinkly29 in reply to Skyblue1202]

White blood cells will also go up with inflammation I think so doesn't have to infection - as in be raised a little which some then think is infection but isn't!

[Lysistrata Administrator Community Ambassador in reply to Skyblue1202]

Some kinds of white blood cells can also go up when you're on oral steroids (the neutrophils) which can raise the total count. Though steroids can also suppress the eosinophils which are the ones which are high in certain kinds of asthma, as Js706 has said. Sometimes if you can reduce your steroids a bit they go up. This doesn't apply to Xolair though.

Good luck with it all, hope you get approval and find it works.

[hilary39]

There are a lot of good threads on this topic in the archives I am on Omalizumab (Xolair) and I've definitely had fewer exacerbations on it though I am still on the same amount of ihalers and antihistamines as before. The big plus for me is I've only had to be on three short courses of steroids in the past year whereas I was on prednisone for months at a time the few years prior.

I haven't had any side effects that I know of though sometimes it's hard to tell between all my meds + my adrenal insufficiency (AI), like I'm losing more hair than normal but I think that's the AI since I developed that last year (?)

Biologics are life-changing for many people so hopefully you'll have a good experience getting assessed for and starting one if it's right for you!

[Skyblue1202 in reply to hilary39]

Thank you. Yeah I'm on a lot of tablets for other things to.

Sounds good about the steroids though. Like you said I can be on them for a long time. If it reduces just that i think I'd be happy.

Thanks for your info everyone

[ninelives]

Hope you feel better soon.

I was also on Xolair which unfortunately didn't work for me and have been on prednisolone for 16 years continuously.

Please ask your doctor's lots of questions re your options.

Very best of luck .

[Keithr24]

Yes. Been on xolair since last ICU stay. Have worked well for me