Understanding biologics
Biologics are a relatively new type of treatment available to treat severe asthma. In this article we look at how biologics work and who can access them in New Zealand.
Currently, using an inhaler is the most common way of treating asthma.
Inhalers contain medicines that relax and open the airways and reduce swelling to allow air to enter the lungs more easily.
For the majority of people, using inhalers (or “puffers”) keeps their asthma under control and allows them to live a healthy and active life.
Some people have severe asthma, which is a type of asthma that is hard to control even using high doses of standard asthma medicines. For these people, a different medication is required.
A relatively new way to treat severe asthma is to use a class of drugs called biologics.
What are biologics?
Biologics are medicines that contain substances that have been isolated from a natural source.
This source includes human cells, microorganisms, plants or animals.
Apart from asthma, biologics have been developed to treat many different diseases, including: cancer, rheumatoid arthritis and psoriasis.
The biologics that have been approved to treat severe asthma in New Zealand are called omalizumab (brand name: Xolair), mepolizumab (brand name: Nucala) and more recently benralizumab (Fasenra).
Omalizumab is used to treat severe allergic asthma, whereas mepolizumab and benralizumab are used to treat people with severe eosinophilic asthma: a type of asthma caused by high numbers of white blood cells that cause swelling and inflammation in the lungs.
All these medications (omalizumab, mepolizumab and benralizumab) work by recognising and blocking substances in the lungs that cause lung inflammation and asthma symptoms.
What does the treatment look like?
Biologics are administered by regular injection every four to eight weeks, depending on the biological medicine used, your weight and asthma severity.
Injections can be given by healthcare providers in a healthcare setting or self-administered at home if your healthcare practitioner deems it safe.
For some people, who struggle to remember to take their inhaler daily, an injection every month or two is a huge benefit of biologics’ treatment.
However, most people still need to take their inhalers as well as having the injections.
What are the benefits of biologics?
The main benefit is that treatment with biologics can improve the quality of life of people with severe asthma and reduce the frequency of asthma flare-ups and hospitalisation.
Biologics also replace the need for high doses of corticosteroids, which can cause unpleasant side effects.
How can I access this treatment?
The number of people eligible for treatment with biologics is relatively small; only people with specific types of severe asthma that cannot be controlled with high doses of corticosteroids can be prescribed omalizumab, mepolizumab, and benralizumab in New Zealand.
In order to be prescribed biologics for asthma, your healthcare practitioner will refer you to a respiratory specialist or a clinical immunologist, who will run tests to determine if you are eligible for biologic treatment.
As asthma is one of the most common chronic diseases across the globe, research in to the condition continues to be relatively well-funded globally.
In the future, we hope to see more biologics and other medicines on the market to further improve the quality of life for people with asthma.