Are you curious about how biologic medications are transforming the treatment of asthma, eczema, allergies, and more?

Dr. Perdita Permaul joins Dr. Gupta and Kortney to discuss the available biologic medications for allergic conditions. We walk through the eight biologics currently available for allergic diseases, explaining how these medications target different parts of the immune system to treat allergic conditions more effectively than traditional medications.

Dr. Permaul explains how biologics have evolved since 2003 and how they are changing the way allergic conditions are treated. She also explains why some of the biologics treat multiple diseases, whereas some are only approved for one.

• How biologics work for allergic conditions: We unpack how biologic medications target specific parts of the immune system, reducing inflammation and improving the quality of life for patients with allergic diseases.
• History and evolution of biologics: Dr. Permaul walks us through the timeline of biologics, starting with Xolair in 2003 and how these treatments have expanded to target other conditions over time.
• Which biologics treat which conditions: From asthma and eczema to food allergies and nasal polyps, we break down which biologics are available and how they help patients with allergic conditions.
• Future of biologics: Dr. Permaul discusses the potential of biologics to be used for more conditions in the future, including ongoing research into food allergy treatments.

Biologics Cheat Sheet

Below is a list of the 8 biologics discussed in this episode. We have briefly outlined their mechanism of action along with the approved conditions and ages the drug is available for presecription.

Omalizumab (Xolair)

Xolair works by binding to IgE to prevent allergic reactions. It has since been approved for chronic hives, nasal polyps, and food allergies.

• Allergic asthma: 6+
• Chronic idiopathic urticaria (hives: 12+
• Chronic rhinosinusitis with nasal polyps (CRSwNP): 18+
• Food allergies:1+

Mepolizumab (Nucala)

Targets and blocks interleukin-5 (IL-5) play a key role in the activation and priming of eosinophils, a type of white blood cell that causes inflammation in asthma.

• Eosinophilic Asthma: 6+
• CRSwNP: 18+
• Eosinophilic Granulomatosis with Polyangiitis (EGPA): 18+
• Hypereosinophilic Syndrome: ≥6 months

Reslizumab (Cinqair)

Targets and blocks interleukin-5 (IL-5).

• Eosinophilic asthma: 18+

Benralizumab (Fasenra)

Binds to the IL-5 receptor, preventing eosinophils from growing and causing inflammation.

• Eosinophilic asthma: 6+
• Eosinophilic Granulomatosis with Polyangiitis (EGPA): 18+

Dupilumab (Dupixent)

Targets and blocks IL-4 and IL-13 to reduce inflammation

• Asthma: 6+
• Atopic Dermatitis: 6 months+
• CRSwNP: 18+
• Eosinophilic Esophagitis (EoE): 1+ (> 33 lbs)
• Approved for prurigo nodularis (PN): 18+

Tezepelumab (Tezspire)

Blocks thymic stromal lymphopoietin (TSLP).

• Asthma: 12+

Tralokinumab (Adbry, Adtralza)

Targets and neutralizes interleukin-13 (IL-13).

• Atopic dermatitis: 12+

Lebrikizumab (Ebglyss)

Targets and neutralizes interleukin-13 (IL-13).

• Atopic dermatitis: 12+ (> 40 lbs)

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This podcast is made in partnership with The Allergy & Asthma Network. Thanks to Sanofi-Regeneron for sponsoring today’s episode. While they support the show, all opinions are our own, and sponsorship doesn’t influence our content or editorial decisions. Any mention of brands is for informational purposes and not an endorsement.

Disclaimer: This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

Do food allergies impact all communities in the same way?

Dr. Vivian Hernandez-Trujillo joins Dr. G and Kortney to discuss the impact of health disparities on allergy outcomes within the Hispanic and Latino communities. Dr. Hernandez-Trujillo highlights the challenges posed by immigration status, language barriers, and cultural factors that contribute to unequal access to healthcare. These disparities often lead to difficulties in managing conditions like food allergies and asthma.

Dr. Hernandez-Trujillo emphasizes the importance of having an advocate in the healthcare system. Dr. G and Dr. Henandez-Trujillo discuss how building a strong relationship with your doctor is key to better outcomes.

Dr. Hernandez-Trujillo also addresses how cultural beliefs and practices within the Hispanic community influence the understanding and management of food allergies and the need for healthcare providers to enhance their cultural competency.

• Health Disparities: Immigration status and language barriers significantly impact healthcare access and outcomes in the Hispanic community.
• Role of an Advocate: Why it is important to have an advocate and maintain a strong relationship with your healthcare provider to navigate the healthcare system.
• Challenges with Allergy Testing: What are the difficulties the Hispanic population faces with allergy testing, including issues related to insurance coverage?
• Cultural Beliefs and Practices: How cultural beliefs and practices within the Hispanic community influence the understanding and management of food allergies.
• Cultural Competency: How healthcare providers can enhance their cultural competency to better serve Hispanic patients.

Dr. Vivian Hernandez-Trujillo is a board-certified allergist and immunologist at Nicklaus Children’s Hospital, where she specializes in treating allergies and immune conditions in children. Dr. Hernandez-Trujillo is deeply committed to addressing health disparities and improving healthcare access for underserved communities. She is actively involved in research and education, focusing on culturally competent care and advocating for patients within the Hispanic community. Her clinical interests include food allergies, asthma, and other allergic conditions.

More resources about XXX:

• ¿Qué es una alergia alimentaria?
• GoogRx Espagñol
• Serie de conferencias virtuales Unidos Hablemos

Starting biologic therapy can be life-changing, but navigating the process isn’t always easy.

Dr. William Anderson joins Dr. Gupta and Kortney to break down the essential steps for starting biologic therapy, covering everything you need to know before beginning treatment. Biologics are at the forefront of managing chronic allergic diseases like asthma and eczema, offering targeted, personalized care that can improve patients’ quality of life. However, accessing these medications often requires navigating a maze of insurance approvals, prior authorizations, and specialty pharmacies.

We dive deep into the challenges patients face when starting biologics—understanding how to get coverage, managing co-pays, and coordinating with specialty pharmacies, all while handling the logistics of administering the medication. As someone who has just started a biologic herself, Kortney shares her own experience and reflects on how this episode provides the exact information she wished she’d had a few months ago.

• Getting informed before starting biologic therapy: Dr. Anderson explains why reviewing your medication’s patient website is a great first step. These resources often include videos and important details about the treatment.
• Navigating insurance and coverage: Insurance is often the biggest hurdle to starting biologics. Dr. Anderson highlights the role your doctor plays in this. Additionally, we discuss the importance of understanding your coverage, prior authorization, and working with specialty pharmacies to ensure you get the medication.
• Administration and storage of biologics: Whether it’s self-injection or infusion at a clinic, we explain how biologics are administered. Dr. Anderson also provides tips on proper storage, including refrigeration and traveling with biologics.
• Vaccines and biologics: Find out whether patients on biologic therapy should avoid live vaccines and how inactivated vaccines like the flu shot are generally safe to take.
• Long-term planning for biologics: Learn about the regular follow-ups and monitoring that are part of managing biologic therapy. Dr. Anderson discusses the importance of staying on track with your doses and follow-up appointments to ensure your biologic works effectively.

About our biologics expert, Dr. William Anderson

Dr. William Anderson, is a board-certified pediatric allergist and immunologist at Children’s Hospital Colorado. With a focus on treating children with complex allergic conditions such as asthma, eczema, and food allergies, Dr. Anderson is known for his patient-centered approach. He has extensive experience in biologic therapies and is dedicated to improving the quality of life for patients through personalized care. Dr. Anderson also actively participates in clinical research, staying at the forefront of advances in allergy and immunology treatments.

More resources about biologic therapies and the conditions they treat:

• A systematic review and expert Delphi Consensus recommendation on the use of vaccines in patients receiving dupilumab: A position paper of the American College of Allergy, Asthma and Immunology
• Biologic Medications Overview
• Understanding Asthma
• Allergies Explained
• Managing Food Allergies
• Understanding Eczema
• What if I Can’t Afford My Eczema Medication?
• What if I Can’t Afford My Asthma Medication?

This podcast is made in partnership with The Allergy & Asthma Network. Thanks to Sanofi-Regeneron for sponsoring today’s episode. While they support the show, all opinions are our own, and sponsorship doesn’t influence our content or editorial decisions. Any mention of brands is for informational purposes and not an endorsement.