Should a 32-year-old with asthma consider biologics?

Question

Hi doctor,

I am a 32-year-old male with severe asthma, and it feels like I am constantly playing defense against my lungs. I have had multiple flare-ups this year, use my rescue inhaler more than I did like, and have needed steroids a few times when things got out of hand.

My pulmonologist briefly mentioned biologic injections, but I did not really know enough at that time to ask questions. Now I am seeing more people talk about them online and wondering if it is something I should revisit.

At what point do people with severe asthma usually start asking about biologics, and how do doctors decide who is a good candidate?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your history and can understand your concern.

I can understand your concern.

See, biologicals are an excellent drug for the right people. If one has eosinophilic asthma, most of the biologicals do great if asthma is not controlled on regular inhalers and the patient is having recurrent exacerbations despite correcting inhaler technique and controlling comorbidities. Even in non-eosinophilic asthma, drugs like Tezepelumab have done tremendously well.

But before opting for biologics, the optimal dose of inhaler for the patient should be tried, and even after that, if the patient's asthma is not controlled, drugs like Benralizumab, Tezepelumab, Dupilamab and even Omalizumab can do tremendously well. They can help in improving the lung function of the patient over time, decreasing exacerbations, and controlling symptoms, but the patient should keep using inhalers along with it. Over time, adherence to biologicals and the dose of inhalers can be titrated.

It is also important to identify your specific asthma phenotype through blood eosinophil counts, IgE (immunoglobulin E) levels, lung function tests, and clinical history, as this helps in selecting the most appropriate biologic therapy.

I hope it helped with the query.

Please let me know if you have any more questions on your mind.

I would be happy to guide you.

Thank you.