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.

Curious about what’s fact and what’s fiction when it comes to biologic medications?

We’re uncovering the truth behind the most pervasive myths about biologic medications with guest Dr. Cedric “Jamie” Rutland. Biologics are revolutionizing the treatment of allergic diseases like asthma and eczema, but misconceptions about their effectiveness, safety, and usage still persist. Dr. Rutland sets the record straight, debunking myths that may be clouding your understanding and decision-making process.

From whether biologics are a cure to concerns about long-term safety and side effects, this episode tackles the most common myths head-on. Dr. Rutland breaks down what biologic therapy truly offers, helping you make informed decisions about your treatment options.

• Are biologics a cure? Dr. Rutland explains that biologics help manage symptoms, but they are not a complete cure.
• Biologics vs. traditional medications: We clarify how biologics differ from traditional medications in the way they target the immune system at a molecular level.
• Do biologics have severe side effects? We dispel myths about severe side effects.
• Long-term effectiveness of biologics: Dr. Rutland talks about how biologics maintain effectiveness over time for most patients.
• Do you have to stay on biologics for life? Learn how long patients typically stay on biologic treatments and whether they are lifelong therapies.
• When should biologics be considered? We address the myth that biologics are only for when all other treatments have failed and discuss when biologics should be introduced.
• Can you stop other medications while on biologics? Dr. Rutland explains that biologics are often used alongside other medications, not as a replacement.
• Who can use biologics? We debunk the myth that biologics are only for adults or that they can't be used if you have multiple health issues.
• Biologics and cancer risk: A common concern, but Dr. Rutland explains the actual risks and dispels the misconception that biologics cause cancer.
• Are biologics immunosuppressive? We discuss how biologics work on the immune system without broadly suppressing it like other treatments might.
• Biologics in medical practice: Dr. Rutland talks about the role of doctors and financial incentives, explaining why doctors prescribe biologics and how they make treatment decisions.
• Do biologics work immediately? Dr. Rutland sets the record straight on how long it typically takes for biologics to start working.
• Biologics are not experimental: Biologics have been widely studied and are not experimental treatments.

• Administration of biologics: We address the myth that biologics must be administered only in hospitals, explaining how patients can receive them at home or in clinics.
• Biologics are not interchangeable: Dr. Rutland explains the importance of sticking with the biologic prescribed specifically for a patient's condition.
• Prescribing biologics: While specialists typically prescribe biologics, we explore how general practitioners can also be involved in the process.
• Lifestyle changes and biologics: We discuss the misconception that biologics eliminate the need for lifestyle changes.
• Are biologics unnecessary for mild symptoms? Dr. Rutland explains that biologics are not only for severe symptoms but can also be considered for other cases.

More resources about biologic therapy and the conditions they treat:

• https://biologicmeds.org/
• https://allergyasthmanetwork.org/what-is-asthma/
• https://allergyasthmanetwork.org/allergies/
• https://allergyasthmanetwork.org/food-allergies/
• https://allergyasthmanetwork.org/what-is-eczema/

What are biologic medications, and how can they help people with allergic diseases?

We discuss biologic medications with Dr. Berger, a leading expert in biologic therapy for allergic diseases. Since the first biologic was introduced in 2003, these treatments have advanced significantly. By targeting the root causes of inflammation, biologics offer a more precise, personalized approach to treating conditions like asthma and eczema. Unlike traditional medications, biologics are a breakthrough, opening the door to tailored care that improves patients' long-term symptom control and quality of life.

Dr. Berger explains biologic medications, how they work at a molecular level, and how they impact the immune system. As Kortney recently started biologic therapy, we also get a firsthand account of patients' decision-making process and concerns when considering biologic treatments. These innovative therapies not only control symptoms but can transform the daily lives of people living with chronic allergic diseases, providing hope for better, long-term outcomes.

• What is a biologic medication? Dr. Berger explains how biologic medications differ from traditional treatments by focusing on precision-based medicine, offering a revolutionary way to target specific aspects of the immune system.
• How biologic therapies target molecular inflammation: Learn how biologic treatments act on specific inflammatory molecules, offering hope for better control and relief for patients with severe asthma, eczema, and more.
• Do biologics suppress the immune system? We address common questions about biologic therapy, its effects on the immune system, and potential side effects.
• The evolution of biologic treatments. A look at how biologic medicine has advanced since 2003 and its role in reshaping asthma therapy and other allergic disease treatments, providing exciting new options for patients.
• Improving quality of life for allergic disease patients with biologics. We discuss how, for many, biologics have been life-changing.
• Steps for patients considering biologic treatment. Dr. Berger offers practical advice for patients interested in discussing biologic therapy with their healthcare providers.

Dr. William E. Berger is a past Clinical Professor in the Department of Pediatrics at the University of California-Irvine and served as Medical Director of Southern California Research in Mission Viejo. He is a board-certified allergist and immunologist with a distinguished career, including roles as President of the American College of Allergy, Asthma & Immunology and as Medical Staff Allergist for the U.S. Olympic Swim Team. Dr. Berger has published over 200 peer-reviewed articles and authored books like Asthma for Dummies, focusing on allergy and asthma treatments. He is widely recognized as an expert in his field, frequently appearing on major media outlets like CNN and Good Morning America.

More resources about biologic therapy:

• https://biologicmeds.org/
• https://allergyasthmanetwork.org/what-is-asthma/
• https://allergyasthmanetwork.org/allergies/
• https://allergyasthmanetwork.org/food-allergies/
• https://allergyasthmanetwork.org/what-is-eczema/

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.

There’s never been a better time to be a CSU patient, with cutting-edge therapies and revolutionary treatments just around the corner. As research accelerates, new and promising options that could significantly improve the quality of life for those living with Chronic Spontaneous Urticaria are coming to market.

In this episode, Dr. Matthew Zirwas joins us to discuss the latest advancements in treating CSU, offering invaluable insights into both current and emerging treatment options. With his extensive experience and patient-centred approach, Dr. Zirwas breaks down the complexities of CSU and highlights how these new therapies can make a real difference.

This podcast was made in partnership with Allergy & Asthma Network. We thank Novartis for sponsoring this podcast.

• How Dr. Zirwas explains CSU to his patients: Discover the patient-friendly explanations that help demystify CSU and empower patients to learn more about their disease.
• When to start with a biologic: Learn about the decision-making process for initiating biologic therapies like Xolair (omalizumab) and when they are most appropriate.
• The new medications coming to market: Get an overview of the latest advancements, including:
  • Dupixent (dupilumab): A biologic administered via injection that targets key pathways in the inflammatory response.
  • Remibrutinib: A BTK (Bruton tyrosine kinase) inhibitor available as a pill that blocks a crucial enzyme in mast cell activation.
  • Barzolvolimab: A promising biologic that targets the C KIT receptor on mast cells to reduce their number.
• Shared decision-making with these medications: Explore strategies for choosing the most appropriate treatment in a rapidly evolving therapeutic landscape.
• Research into the underlying cause of CSU: What’s happening on the research front to uncover the root causes of CSU.

Dr. Matthew Zirwas, MD, is a board-certified dermatologist and a nationally recognized expert in allergy patch testing, psoriasis, and eczema. He founded the Bexley Dermatology Research Clinic, offering patients access to the latest treatment options before they are widely available. Dr. Zirwas also serves as a dermatologic advisor for several companies, including ALL Laundry Detergent and Cerave, and contributes to Women’s Health Magazine. Learn more about Dr. Zirwas.

More resources about chronic spontaneous urticaria:

• Chronic Urticaria Management, Resources & Glossary of Terms: https://allergyasthmanetwork.org/health-a-z/chronic-urticaria/management-and-resources/
• What is Chronic Urticaria: https://allergyasthmanetwork.org/health-a-z/chronic-urticaria/
• More information about Omalizumab (Xolair): https://www.xolair.com/chronic-spontaneous-urticaria.html

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.

Did you know that the month of September sees a drastic rise in asthma attacks and hospitalizations?

Dr. G and Kortney delve into the challenges that asthmatics face during the fall season, also known as "peak week." Despite what the name suggests, asthma cases start to rise in the second week of September and continue into early October before returning to normal levels.

We begin by defining asthma and then explore why asthma attacks are more prevalent in September. We discuss the role of germs and viruses, indoor and outdoor allergens, and cold weather in exacerbating asthma symptoms. Dr. G also shares tips on how to lessen your exposure to these triggers. Additionally, we cover the importance of having an asthma action plan and the significance of well-controlled asthma.

Dr. G also discusses the financial aspects of asthma management and offers advice on how to discuss this with your doctor.

>>>> Listener survey: https://forms.gle/6Pb2PGq6nuVReasZ6

• Why September is Peak Asthma Season: Explore why asthma attacks increase in the fall and what you can do to prepare.
• The Role of Germs and Viruses in Asthma: Understand how illnesses can trigger asthma and learn tips for staying healthy.
• Indoor and Outdoor Allergens: Discover how common allergens like dust mites, pet dander, ragweed, and mold can affect asthma, and what you can do to limit exposure.
• Preparing for Peak Week: Essential steps to take before asthma season hits, including scheduling doctor visits and creating an action plan.
• Asthma Management Tips for Different Age Groups: Advice for school-aged children and elderly patients to ensure they receive the best care.

More resources about asthma peak week:

• Asthma and Allergy Forecast: pollen and allergen count https://allergyasthmanetwork.org/weather/
• 10 Ways to Stay Healthy During the September Asthma Peak Week https://allergyasthmanetwork.org/news/10-ways-to-stay-healthy-during-september-asthma-peak/
• Seasonal allergies: https://allergyasthmanetwork.org/news/seasonal-allergies/
• Asthma attack: https://allergyasthmanetwork.org/what-is-asthma/asthma-attack/
• What if I Can’t Afford My Asthma Medication? https://allergyasthmanetwork.org/what-is-asthma/what-if-i-cant-afford-my-asthma-medication/
• Asthma Management and Control (2:2:1 Rule) https://allergyasthmanetwork.org/what-is-asthma/asthma-management-and-control/
• AirQ https://www.airqscore.com/en/main-page.html
• ACT Test https://www.asthmacontroltest.com/welcome/

We want to thank AstraZeneca for sponsoring this episode.

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.

This episode is a quick-fire round covering the misunderstood aspects of chronic spontaneous urticaria (CSU), a condition that perplexes many due to its spontaneous nature. With over 1.7 million people affected, it's more common than you might think and deserves a closer look. Despite its prevalence, many misconceptions persist about what causes CSU, its symptoms, and how it can be treated.

Kortney and Dr. Gupta tackle the myths and misconceptions around CSU. Unpacking its impacts on quality of life and the challenges those living with the condition face. They explore the realities of living with CSU, from the pervasive itch to the emotional toll it can take. Whether you're a patient, caregiver, or healthcare professional, this episode offers valuable insights into the realities of managing CSU.

This podcast was made in partnership with Allergy & Asthma Network. We thank Novartis for sponsoring this podcast.

• CSU is caused by allergies.
• CSU is contagious.
• CSU is a rare condition.
• CSU is not a serious condition.
• Stress is the main cause of CSU.
• CSU only affects the skin.
• CSU will go away quickly.
• There isn’t any treatment for chronic hives.
• Antihistamines are the only treatment for CSU.
• Changing your diet will help CSU.
• CSU can be cured.
• Once CSU goes away, it will never come back again.
• Men and women are equally affected by CSU.
• You can always pinpoint the exact cause of hives in patients with CSU.
• Autoimmune conditions are more common in people with CSU.
• Scratching hives is harmless.
• Once my hives are controlled, I need to be on the medication forever.
• All hives look the same.
• Only adults get CSU.
• CSU hives are always accompanied by other allergic symptoms like swelling or difficulty breathing.
• Having CSU doesn’t affect quality of life.
• The itch in CSU is not a big deal.
• Allergy testing will help me figure out why I have CSU.

More resources about chronic spontaneous urticaria:

• Chronic Urticaria Management, Resources & Glossary of Terms: https://allergyasthmanetwork.org/health-a-z/chronic-urticaria/management-and-resources/
• What is Chronic Urticaria: https://allergyasthmanetwork.org/health-a-z/chronic-urticaria/
• More information about Omalizumab (Xolair): https://www.xolair.com/chronic-spontaneous-urticaria.html

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.