Biologics

We are constantly looking for innovative and effective ways to improve the lives of our patients. Biologic treatments, derived from living organisms, work to reduce bodily inflammation from the inside by targeting different components of an individual’s immune system.

What are Biologic treatments?

As medical technology continues to expand, so do allergy and immunotherapy treatment options. There are a few different biologic treatment options that alleviate conditions that may not respond as well to traditional therapy, such as oral medications or immunotherapy. Ask your allergist/immunologist if any of the following may be right for you.

Xolair (omalizumab)

Xolair is a biologic treatment that was FDA approved in 2003 for subcutaneous use as an injectable prescription medicine. It works by binding to an allergic antibody in the bloodstream (called the IgE antibody), thereby blocking its action. High levels of IgE can contribute to a variety of allergic conditions, such as eczema, asthma, and urticaria (hives). Xolair is used to treat:

• Moderate to severe persistent asthma in individuals who are 6 years old and older whose asthma symptoms are either poorly or not fully controlled with asthma medications. An allergy test is performed to determine if you have allergies to year-round allergens, such as pet dander, molds, dust, and/or cockroach debris. An additional blood test for levels of blood IgE must be performed to determine the appropriate dose and dose frequency.
• Nasal polyps of individuals at least 18 years old whose previous use of nasal sprays (corticosteroids) have not helped alleviate their polyps. An additional blood test for levels of blood IgE must be performed to determine the appropriate dose and dose frequency.
• Chronic idiopathic urticaria (also known as CIU and defined as chronic, recurring hives without a known underlying cause) in individuals who are 12 years of age and older whose hives are poorly controlled with their current CIU medications.

How do I receive this treatment?

• Xolair injections are given in a healthcare setting and under the surveillance of a healthcare provider.
• Xolair injections are given in 1 or more injections subcutaneously (under the skin) once every 2–4 weeks. After receiving your injection, you will be monitored for 30–45 minutes for your own safety. Healthcare staff will watch for potential side effects.
• You may not notice an improvement in symptoms right after your first Xolair treatment, but rather, may notice changes gradually as you continue with this therapy.
• It is important that you do not stop taking your current asthma, nasal polyps, or urticaria medications without first consulting your allergist/immunologist.

The most common side effects of Xolair use in adults and children over the age of 12 include bodily aches, dizziness, fatigue, or injection site reactions. In children from ages 6 to 12, they may experience common cold symptoms such as headache, fever, sore throat, abdominal pain, nausea, or vomiting. In addition there is a possibility that patients receiving Xolair may experience anaphylaxis, though this is very rare. If you have any additional questions or concerns, speak to your allergist/immunologist to decide if Xolair right for you. To learn more about Xolair (omalizumab), visit their website.

Nucala (mepolizumab)

Nucala is a biologic treatment that was FDA approved in 2015 for subcutaneous use as an injectable prescription medicine. Nucala works by controlling an individual’s high levels of circulating eosinophils (a type of white blood cell). It does so by blocking a specific immune system protein (called Interleukin-5, IL-5) that promotes the release of eosinophils into the bloodstream. This helps to avoid exacerbations of inflammation that high levels of eosinophils can cause in a person’s airways. Nucala is used to treat patients who are 12 years of age or older whose eosinophilic asthma is difficult to control by other asthma medications. If you or your physician suspect you may have eosinophilic asthma, a blood test can determine the number of eosinophils in your blood. How do I receive this treatment?

• Nucala injections are given in a healthcare setting and under the surveillance of your healthcare provider.
• Nucala injections are given once every 4 weeks. After each injection, you will be monitored by healthcare staff for 30-45 minutes for your own safety.
• You may not notice an improvement in symptoms right after your first Nucala treatment.
• It is important that you do not stop taking your current asthma medications without first consulting your allergist/immunologist, as Nucala is FDA-approved as an add-on medication, working to control your asthma with the medications you are already taking.

Common side effects of taking Nucala include headaches, back pain, fatigue, or injection site reactions. There is also a possibility (though very rare) that patients may experience side effects after taking Nucala, such as anaphylaxis. If you have any additional questions or concerns, speak to your allergist/immunologist to decide if Nucala right for you. To learn more about Nucala (mepolizumab), visit their website.

Dupixent (dupilumab)

Dupixent is a biologic treatment that was FDA approved in 2017 as a maintenance treatment administered through subcutaneous injection. Unlike most other biologic treatments, Dupixent can be taken at home after proper training performed by healthcare staff. Dupixent works by blocking two interleukins (immune system proteins IL-4 and IL-3) that can contribute to atopic dermatitis. This helps lower overall levels of inflammation in the body, leading to fewer exacerbations of diseases like atopic dermatitis and some forms of asthma. Dupixent is used to treat:

• Moderate-to-severe atopic dermatitis (also known as eczema) in individuals aged 6 years and older whose eczema is not well controlled with traditional treatments, such as topical prescription therapies.
• Moderate-to-severe eosinophilic or oral steroid-dependent asthma in individuals aged 12 years and older whose asthma is not well-controlled with traditional asthma medications. Dupixent is considered an add-on treatment. Unless your doctor says otherwise, it is important to keep taking your current asthma medication while taking Dupixent.
• Chronic rhinosinusitis with nasal polyposis in adults 18 years or older whose disease is poorly controlled. Dupixent is considered an add-on treatment. Unless your doctor says otherwise, it is important to keep taking your current medications for nasal polyps while taking Dupixent.

How do I receive this treatment?

• Initially, a demonstration of Dupixent use will be performed in a healthcare setting and under the surveillance of your healthcare provider.
• Dupixent injections can be self-administered once every other week. Individuals who are 6 to 11 years old require an adult to administer their Dupixent. Individuals who are 12 to 17 years old may self-administer thier own Dupisent under the supervision of an adult.
• You may not notice an improvement in symptoms right after your first Dupixent treatment.
• It is important that you do not stop taking your current medications without first consulting your allergist/immunologist, especially if you are taking Dupixent for moderate-to-severe asthma or for nasal polyps.

Common side effects of taking Dupixent include localized injection site reactions, eye/eyelid inflammation (for those taking Dupixent for atopic dermatitis or for nasal polyps), and sore throat (for those taking Dupixent for asthma). Like all other biologics, there is a very rare chance that you may experience an anaphylactic reaction after Dupixent use. If you have any additional questions or concerns, speak to your allergist/immunologist to decide if Dupixent is right for you. To learn more about Dupixent (dupilumab), visit their website.

Next steps

If you are interested in further discussion about your specific needs, Dr. Reshamwala is happy to see you and answer any questions you may have. Please call (512) 535-2655 or email clinic@frontierallergist.com to schedule an appointment today! Book an appointment