I have emphysema caused an underlying genetic condition Alpha-1 Antitrypsin Deficiency. I have been on Symbacort for years with no issues and have never had thrush. I have been doing Fasenra shots (prescribed by local allergist) successfully for four years now and it brought my eosinophil count to zero. I've had no negative reaction and like that I only have to do shots every eight weeks. Started seeing a pulmonologist at Mayo Clinic this past year who is high on Airsupra so I do that successfully during times of viral infections. Her top biologic suggestions are Dupixent and Teszpire. I tried Dupixent and it gave me extreme head/neck pain for two days so I stopped and went back to Fasenra. My child with same lung issues has been on Xolair shots successfully four years and now gives them to herself monthly at college with success. I HIGHLY recommend biologics. They do make a difference.