Are biologics (Xolair, Dupixent, Nucala or Fasenra) really worth the cost & side effects

[TmTx]

I have asthma as well as elevated eosinophols (~850 mcL). The asthma is well controlled with an inhaler, but I have some concerns with long-term use of an inhaler so my interest is peaked by all of the advertisements about the various biologic treatments. For those who take one of these biologics - would you recommend them to someone who has relatively well controlled asthma with use of inhalers?

[MommaMich]

My asthma was somewhat controlled, but I was having multiple attacks (4-5/year) 2 or 3 of those would require steroids and an occasional trip to ER. I have been taking Nucala injections for 2 yrs now. I have maybe 1-2 attacks which did not require ER and was quickly under control. I also have COPD, often asthma can trigger a flare, and those seem fewer as well & easier to treat because the asthma is controlled

[FightingAsthma]

I started Nucala injections in November 2021 because I kept getting recurring chest infections (as in every month), and I went for tests and they told me I have EA.

My experience has been really positive, apart from the first 3 months where I felt no difference. Now I’m training for race for life and weight training again!

I still do get the odd infection, but I recover quicker and I think it’s been worse since I had covid to be honest.

I suppose if you feel you don’t really need it, leave it? Unless you think your quality of life will improve because of it.

I still have to use my steroid inhalers and montelukast everyday though.

[Dairyman11]

I have been on Nucala, but have switched to Fasenra. If you are managing to control your asthma without the use of oral steroids, I would leave it as is.

[Tree20862]

Talk it over with your doctor.

It is my understanding that the people who benefit from biologics, and can qualify for co-pay assistance, are people on daily oral steroids or people who have multiple exacerbations requiring steroids during the year to treat their asthma, on top of their daily inhalers and other oral meds.

It is a process to get approval every year, too. I have been lucky enough to get it for the last 6.5 years. Every renewal I get anxious that this will be the year that the pre authorization will be denied. 🍀🤞🍀🤞🙏 This is also the first year my doctor has started to cut back on my steroid inhalers.... From 2 inhalers to 1!

[Mijmijkey74]

If asthma well controlled with inhaler use then you have no need for biologics. Their is criteria that must be met. If it simply the inconvenience of inhalers that made you ponder about injections iinstead? I'd still advise against. I have fasenra injections, they cause whole body aching, but that is outweighed by the fact I now do not consistently fall ill with chest infections and asthma flare ups leave me requiring antibiotics and steroids and these injections help keep me out of hospital as an inpatient. Maybe discuss them with your respiratory nurse/specialist and see what they suggest if you haven't done so already given it is now four months later since you posted.

[Subicbay]

My experience with Dupixent

For many years, I have been suffering from chronic sinus infection, eczema and asthma due to environmental allergies. I have been on Dupixent for over 2 years. Dupixent got rid of nasal polyps and my asthma was under control. But for the past 6-8 months, I have experienced severe headache, blurry vision and joint pain. One of the side effects of Dupixent is Blepharitis, headache and joint pain. My rheumatologist told me to stop Dupixent until farther notice just to see if my condition improve. It did. My headache had calm down. I'm on ocusoft for Blepharitis and Xiidra for dry eyes which i believed are side effects of Dupixent. My allergist is switching my med from Dupixent to Nucala. My concern is Nucala may have the same side effects as Dupixent. I'm undecided whether to take Nucala my concern is the side effects that I had experienced with Dupixent.