Are biologics or allergy tests needed for my asthma?

Question

Hello doctor,

I have had asthma since childhood, but lately my symptoms have been getting worse, especially at night with wheezing and shortness of breath. My recent spirometry results showed an FEV1 of 68 %, and my IgE level was 265 IU/mL, which is slightly elevated.

I currently use a Budesonide inhaler, but it does not seem to control my symptoms well anymore. I want to know:

Should I discuss starting biologic injections like Dupilumab or Omalizumab with my doctor?
Would allergy testing help identify possible triggers that worsen my asthma?
Is it safe to increase the inhaler dosage on my own during flare-ups, or should I only adjust it under medical guidance?
Finally, do you recommend getting a CT chest scan to rule out other lung problems?

Please help.

Thank you in advance.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Since your IgE level (immunoglobulin E, a blood marker linked to allergies) is a bit high and your asthma is still not well controlled despite using inhaled steroids, you may benefit from biologic therapy. These are special injection treatments like Omalizumab or Dupilumab.

They are usually given to people with moderate to severe asthma when regular inhalers are not enough. Please discuss this option with a pulmonologist (lung specialist).

Allergy testing can be useful to find out what is triggering your asthma, like dust, pollen, or pet dander. Avoiding these triggers can help reduce flare-ups.

About your inhaler dosage, please do not increase it on your own. Only your doctor should decide on dosage changes. Sometimes, instead of just increasing the dose, doctors add another type of medicine called a long-acting bronchodilator (a drug that relaxes the airway muscles) along with the steroid inhaler for better control.

A CT (computerized tomography) chest scan is not usually needed for asthma. It is only considered if your doctor suspects another lung problem or if something unusual is seen on your exam or chest X-ray.

My advice is:

See a pulmonologist for a full asthma control check.
Keep a symptom diary (note when your symptoms get worse).
Make sure you are using the inhaler with the correct technique.
Follow up regularly with your doctor.
Lifestyle matters too: avoid allergens, maintain a healthy weight, and keep up with vaccinations (like flu shots).

I hope this helps.

Kindly revert so I can assist you further.

Thank you.