Biologics for asthma

[BG2015]

Is anyone currently having these injections for their asthma? My respiratory nurse is putting me forward for them as we just can't get my asthma under control.

I'm now on Fostair, Spiriva Respimat, Montelukast, Ventolin and now Uniphyllin. I'm also on my 7th course of steroids in 8 months as my peak flow is so low (160 for the past week) and it's the only thing that helps. I can't stay on them long term because of being prone to osteoporosis.

I just wondered how you've found them and what's the procedure for them long term

Thanks

I did an asthma healing program and got rid of it completely. Learnt so much about my body and how it heals.

My husband used to work on a biological for asthma, omalizumab. I assume since you are being prescribed anti-interleukin 5 monoclonals this is because they want to target the eosinophilic inflammation as closely as possible.

However, are you allergic to things, and are you atopic (raised IgE, the allergy immunoglobulin that binds allergens)?

If so omalizumab (Xolair) may be an alternative. If effective (it doesn't work for everyone) its mechanism - binding IgE - is upstream and so independent of eosinophils. IgE is responsible for both immediate hypersensitivity (as with rhinitis, urticaria, bee stings, food allergies, etc) and T-helper 2 cell (allergy side of the immune system) driven inflammation.

Been following this thread.

@Cyclistmumgrandma thank you for your very timely post. I'm finally going to start Omalizamub injections next week via my Immunology consultant. She had explained all the benefits to my at my last appt, but I'm totally sold now (I'm on two inhalers for modeate asthma and four antihistamines a day to try and keep my Chronic Urticaria under control) It's a no brainer for me, really.

Sorry to jump on the thread. Just goes to show how much threads can help others. Sending best wishes to all.

I have no allergies to anything.

So yesterday I had my first Fasenra (benralizumab) injection, after the Nucala injections failed. The Nucala reduced my eosinophilis but my lung function still remained very poor.

I'm hoping that this injection is the one that actually works. I had a further two weeks off in November after a chest infection and massive asthma flare where I had antibiotics and prednisone. I have lost count of the number of steroids I've had in the past 12 months.

I can only have 2 courses of steroids on this injection, anymore and it means it's not controlling my asthma so I will then have to try another biologic!

The nurse said yesterday some people have literally had them all and still struggle.

Fingers crossed for you @BG2015. Are they doing full bloods on you each visit? Husband saw a remarkable drop in eosinophils numbers from the first injection onwards. It took about 9 months in total but his blood levels are “normal” now. I sincerely hope this works for you.

Yes, same as the previous drug. Regular bloods and spirometry tests.

@SilverPearl is your DH breathing all good now then?

@BG2015 His lung capacity is up about 40%, mucus problems decreased, all since treatment started last spring. If it works, it starts working very soon after the first injections. Really hope it works for you.

That's brilliant @SilverPearl I'm so glad it's working.

How does he cope with the 8 weekly injections? Does he feel it waning towards the end of the 7/8th week?

He had no adverse reactions to the injections, he does get slightly more breathless about 5 days before the injection is due, but nothing debilitating . He self injects now, can’t fault the supply chain. The delivery company know the injection schedule you are on and arrange the supply of injections 2 packs at a time. We simply keep them in the fridge until they are needed. I really hope you get similar relief. You’ve had poor control for years same as him from what you’ve posted.
I am an evangelist for this treatment for any eosinaphilic asthma sufferers. The more success stories there are, the greater will be the awareness at GP and asthma nurse level and more people will get referred.

Another update.

So I've now had 3 Fasenra injections. These were 4 weeks apart. The 4th is due next Wednesday and I've had to wait 8 weeks for this one.

The first 5 weeks were great, hardly any cough, not really breathless and we even went on holiday. But the last three weeks have been horrendous. My peak flow is about 240 and I'm even waking in the night coughing and having to use my inhaler. I couldn't go for a walk now.

My eosinophils are 0 and last time I had a slight increase in my lung function from 48% to 52%, so not great.

I have FENO and spirometry tests before my injection on Wednesday so will be interesting to see what the numbers are this time.

BG2015 so the Fasenra had worked to knock back the eosinophils, but you still have asthma? Are you still on Prednisalone? Husband is on 5mg daily after a year of Fasenra.

We used Natural Body Intelligence that did wonders for our daughter.

Still got asthma symptoms. Today has been really bad.

Not taking pred no, I am allowed 2 courses of steroids - anymore and they will take me off the Fasenra as it will be demmed to not be working.

Very wary of taking any long term steroids as I have the start of osteoporosis and steroids make it worse.

When I was on the Nucala my eosinophils were zero too but lung function and inflammation were high.

If the Fasenra was every 6 weeks I'd be laughing but don't think the NHS want to fund it every 6 weeks.

Another update from me. I've now had 4 Fasenra injections and due to take my 5th one next week (it's being delivered this morning).

I can finally say I've had 8 weeks of feeling totally normal. My eosinophils are zero. My lung function is improving. I'm going for FENO and spiro tests this afternoon so hopefully there will be an even bigger improvement now.

I've had a bit more coughing this week and woke up quite breathless as the drug is obviously waning now but nothing I can't cope with.

Long May it continue 👍🏼

Oh that's fantastic, long may it continue indeed! I'm really pleased you've managed to get onto something that is helping.

January lung lung function was 41%
Now it's 59.4%

🎉🎉🎉