Has anyone taken Biologics?

Posted by Teresa, Volunteer Mentor @hopeful33250, Jul 6 10:58am

I'm somewhat new to asthma and lung problems. In December, I had my first visit with a pulmonologist who prescribed a steroid inhaler and an Aerobika. They were helpful; however, there were still times when these did not work as well as I expected. Six months later, during my follow-up appointment, the pulmonologist added Singulair, which has also been helpful. He did mention he was considering prescribing a biologic.

I'm still having times when all of the previous treatments are not effective, and I'm going to the ER or urgent care for a breathing treatment and Prednisone; I'm probably going to be discussing biologics at my next appointment. If you have been prescribed biologics, please share your experiences.

Interested in more discussions like this? Go to the Asthma & Allergy Support Group.

Profile picture for pht1123 @pht1123

Hi Everyone -
I am only speaking from my personal experiences and not telling you what to do - as this is between you and your provider.
I am asthmatic for 60 years - with quiet times as well as exacerbations. (The last 10 years have been more difficult.) I am a steroid dependent asthmatic with other health issues from the medications of all these years. I was on Xolair for about 15 years - which was one of the first biologics. It helped tremendously, but is now being used as a biologic to help with food allergies in children. I was on Singulair (and Accolate - very similar), but it is really being used as an allergy medicine now.
After Xolair, the choice was either Tezpire or Dupixent. We had opted for Tezpire, as it was the newest and had a different route in the body to help. For me, Tezpire worked only 6 weeks, and I got progressively sicker (hospitalized). I then switched to Dupixent - which thankfully, has been a tremendous help for me (on it about 2 years). Biologics can take up to 14 weeks before they kick in - so please give whichever one you use, time to work in your system. I do not have experience with other biologics.
Regarding Prednisone - it is a great medication to help with the asthma - but has numerous side effects on the whole body - not just the lungs. Be careful, and work closely with your provider. Trelogy is relatively new - triple medication - but if you are allergic to milk - it may not be good for you. Breiztri is good, but also be aware of side effects from everything and READ! (This also can cause visual changes.) Many use a steroid inhaler as maintenance medication.
Nebulizers can help - albuterol as needed per your provider, as well as Brovana (Arformoterol Tartrate) which is a long acting type of albuterol in nebulizer. There are many different nebulizer medications which can be helpful.
Asthma can also be confused with other respiratory conditions - including obstructive sleep apnea as well as cardiac conditions (congestive heart failure) or other heart problems.
Read everything, work closely with your provider and do not do "over the counter" preparations on your own (Primatine Mist - which can rapidly increase heartrate).
Magnesium supplements do help as well. Try to stay hydrated as medically allowed and keep an asthma diary of your symptoms as well as what is helping to alleviate the symptoms. You must advocate for yourself, but be open to reading and discussing what will be your best course to feel better. Good luck!

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I really appreciate you sharing your experiences with biologics and other medications you have used for a rather long history of asthma, @pht1123. You have provided some great information, especially about biologics needing 14 weeks before any improvement is shown. I would not have thought the time period to be that long.

Do you practice any other breathing therapies? Have you found any specific allergies that trigger your asthma?

REPLY

Hi Everyone -
I am only speaking from my personal experiences and not telling you what to do - as this is between you and your provider.
I am asthmatic for 60 years - with quiet times as well as exacerbations. (The last 10 years have been more difficult.) I am a steroid dependent asthmatic with other health issues from the medications of all these years. I was on Xolair for about 15 years - which was one of the first biologics. It helped tremendously, but is now being used as a biologic to help with food allergies in children. I was on Singulair (and Accolate - very similar), but it is really being used as an allergy medicine now.
After Xolair, the choice was either Tezpire or Dupixent. We had opted for Tezpire, as it was the newest and had a different route in the body to help. For me, Tezpire worked only 6 weeks, and I got progressively sicker (hospitalized). I then switched to Dupixent - which thankfully, has been a tremendous help for me (on it about 2 years). Biologics can take up to 14 weeks before they kick in - so please give whichever one you use, time to work in your system. I do not have experience with other biologics.
Regarding Prednisone - it is a great medication to help with the asthma - but has numerous side effects on the whole body - not just the lungs. Be careful, and work closely with your provider. Trelogy is relatively new - triple medication - but if you are allergic to milk - it may not be good for you. Breiztri is good, but also be aware of side effects from everything and READ! (This also can cause visual changes.) Many use a steroid inhaler as maintenance medication.
Nebulizers can help - albuterol as needed per your provider, as well as Brovana (Arformoterol Tartrate) which is a long acting type of albuterol in nebulizer. There are many different nebulizer medications which can be helpful.
Asthma can also be confused with other respiratory conditions - including obstructive sleep apnea as well as cardiac conditions (congestive heart failure) or other heart problems.
Read everything, work closely with your provider and do not do "over the counter" preparations on your own (Primatine Mist - which can rapidly increase heartrate).
Magnesium supplements do help as well. Try to stay hydrated as medically allowed and keep an asthma diary of your symptoms as well as what is helping to alleviate the symptoms. You must advocate for yourself, but be open to reading and discussing what will be your best course to feel better. Good luck!

REPLY
Profile picture for Teresa, Volunteer Mentor @hopeful33250

Hello @judilynn2, and welcome to Mayo Connect.

There is a discussion on Tezspire, @judilynn2. Here is the link to that discussion:
https://connect.mayoclinic.org/discussion/tezspire/
What other asthma medications and/or treatments have you tried so far?

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@hopeful33250 I am on Advair 500/50, singulaur, and Spiriva REspimat with a rescue inhaler and Ipratrobium Bromide and Albuterol Sulfate Nebulizer. From my ENT doctor I also have a sinus rinse plus 2 sinus sprays. Actually I have had asthma since I was around 18 years old but it seems to have always been well controlled. Another time it was out of control and I had respiratory arrest. That was almost 40 years ago now. I did recently spend 6 days in ICU and it is since this spring that I always seem to have this phlegm and coughing plus using PEP apparatus, etc. When I saw the doctor on Friday is when he suggested perhaps Tezspire. After reading the comments, I'm not sure I want the side effects of pain they report. Of course the price is prohibitive too.

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I just started Dupixent for asthma three months ago and so far have had no side effects or problems with it. But it's a little early to know how much it is helping as I'm also trying to get over bronchiectasis and a MAC infection that became evident last December and was finally diagnosed this past May. I'm on a rescue inhaler, a steroid inhaler and now Dupixent for my asthma and I'm doing a nebulizer with the Aerobika PEP device and huff coughing twice a day to try to get rid of the MAC. No antibiotics for the MAC yet because I have been very slowly getting better without them.

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Profile picture for judilynn2 @judilynn2

I get so tired of breathing through the mucous in my bronchaii/my asthma. My pulmonologist has recently suggested the biologic TEZSPIRE. Has anyone tried that? The costs are wild!

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Hello @judilynn2, and welcome to Mayo Connect.

There is a discussion on Tezspire, @judilynn2. Here is the link to that discussion:
https://connect.mayoclinic.org/discussion/tezspire/
What other asthma medications and/or treatments have you tried so far?

REPLY

I get so tired of breathing through the mucous in my bronchaii/my asthma. My pulmonologist has recently suggested the biologic TEZSPIRE. Has anyone tried that? The costs are wild!

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I have been on tezpire for five months. They have also tried a few of the others. None of them seem to help me. Besides asthma I have moderate emphysema and use Trelegy for that.
I have heard some people say that it does help them.

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Profile picture for Teresa, Volunteer Mentor @hopeful33250

I don't understand the "21", @ricktweld. Is that an oxygen setting or the number of days you use it?

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@hopeful33250 sorry, that is supposed to be 2 liters of oxygen.

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Profile picture for ricktweld @ricktweld

@hopeful33250 my treatment is 2l of continuous oxygen through a nasal cannula while sleeping.

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I don't understand the "21", @ricktweld. Is that an oxygen setting or the number of days you use it?

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Profile picture for kay60 @kay60

I have been taking 300mgs of Nucala since February 2025. It's doesn't seem to be working as well. I been coughing, wheezing for 3 months, back to using rescue inhaler, nebulizer and prednisone!! Yuk...
Prednisone makes my heart rate and blood sugar, ect... My energy level is good considering I'm supposed to have pneumonia!!!!
So I've had xrays, CT scan with a diagnosis of new nodules in my right lung...Dr said that I have pneumonia as well, He wanted me to go to ER and get admitted for the so called Pneumonia, but I have NO infection or fever, just loose congestion that won't completely go away... I know my body better than the Dr so decided to wait and take the prednisone for a week, so far it seems much better...Somedays are better than others. So my pulmonary Dr wants me to switch me to Dupixent..I've read it has more side effects than Nucala...My question is, if your taking Dupixent, how are you doing and what side effects have you had? Thanks

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@kay60 - you might check out this discussion on that medication:

-Anyone have experience with Dupixent for asthma?https://connect.mayoclinic.org/discussion/asthma-and-dupixent/

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