The Role of Biologics in Treating Severe Asthma

Asthma is considered a heterogeneous condition due to the lack of a one treatment approach to cure all variations of the disease. 

Several factors further complicate the treatment of severe asthma, including:

• The complex immune dysregulation that occurs in the disease 
• The interaction between the patient’s innate and adaptive immune systems 
• Genetic and environmental factors

These factors contribute to the disease variability noted in the severity of the condition, its airway inflammation patterns, and the treatment success.

Severe Asthma in America

In December of 2018, the Institute for Clinical and Economic Review (ICER) released their final evidence report concerning biologic therapies for the treatment of asthma.

In the report, they quote the latest asthma estimates in the United States:

• 20.4 million Americans over the age of 18 years currently have asthma, and an additional 6.1 million children have asthma

• Every year there are approximately 14.2 million office visits, 1.8 million emergency room visits, and 440,000 hospitalizations due to asthma 

• The societal costs are estimated to be $82 billion, including $50 billion in direct medical costs, $29 billion from asthma-related mortality, and $3 billion from missed work and school.

Although patients with severe asthma represent fewer than 5-10% of all individuals with asthma, they account for approximately half of all costs, making them a small but significant subset of asthma patients.

Unfortunately, as is often the case, mortality and economic impact are higher in patients whose condition does not respond adequately to combinations of inhaled corticosteroids and preventive measures, causing these patients to have a higher risk of developing more frequent exacerbations and severe consequences of airway remodeling.

Types of Biologic Therapy Drugs for Asthma Treatment

The medical community has come a long way since Hippocrates first recorded a link between asthma symptoms and environmental triggers. However, despite intense research in the field, asthma remains cataloged as an incurable disease.

The good news is that extensive research conducted in recent years, has led us to better understand the cause and development pathway of this condition, which has facilitated the creation of target-specific drugs known as biologics.

Currently, Altus Infusion provides private practices with the following biologic therapy drugs for the treatment of asthma patients:

 

Xolair® (Omalizumab)

Omalizumab is one of the first biologic drugs approved by the FDA for the treatment of moderate to severe asthma in patients 12 years and older. 

Xolair® is a humanized monoclonal antibody intended to help patients with poorly controlled asthma and allergies to year-round allergens such as dust mites, pet dander, and cockroach debris.

Xolair blocks the antibody that causes an allergic asthma response. It is administered as one or two subcutaneous injections at 2 to 4-week intervals.

Nucala® (Mepolizumab)

Mepolizumab is a humanized monoclonal antibody used in the treatment of severe eosinophilic asthma by blocking IL-5, a signaling protein of the immune system. Nucala® is a prescription maintenance treatment for patients 12 years and older.

Mepolizumab is administered as a subcutaneous injection once every 4-weeks.

 

Cinqair® (Reslizumab)

Reslizumab is an IgG4/κ humanized monoclonal antibody also directed against IL-5. Like Mepolizumab, it works by reducing the number of eosinophils in the patient’s blood and sputum. 

Cinqair®, unlike the previous two asthma biologic drugs, is administered via an intravenous infusion. Infusions last between 20 and 50 minutes and are delivered once every 4-weeks.

 

Fasenra® (Benralizumab)

Benralizumab is a humanized monoclonal antibody directed against the α-chain of the IL-5 receptor. Although Benralizumab targets the IL-5 receptor like Reslizumab and Mepolizumab, Fasenra® is unique in that it not only blocks the effects of IL-5 on eosinophils, but also results in eosinophil death through cell-mediated cytotoxicity.

Fasenra® is a subcutaneous injection administered once every four weeks for the first three doses, after which it is administered once every 8-weeks.

Altus Infusion specializes in biologic management services, which includes the creation and operation of in-office infusion suites as well as the supplying of injection therapies. 

As an industry leader, we are committed to ensuring that private practices and their patients have access to the most effective biologic treatment drugs as they come to market.

For more information on how Altus Infusion can help your private practice, please email us at info@altusbiologics.com.