Calling Dr. Bauer …

Those with chronic medical conditions often ask, “Is there something ‘new’ to treat my illness”? I would like to tell you about a new therapy available to some people with chronic moderate-to-severe asthma who do not respond to standard inhaler options.

Some people with allergy-based asthma have high circulating levels of a blood protein called Immunoglobulin E (IgE) and/or high amounts of white blood cells named eosinophils. When elevated, these indicate asthma may be out of control. These blood components cause the release of other proteins that trigger airway inflammation and obstruction (wheezing) plus all sorts of typical allergy symptoms.

A new class of medication called “biologic therapies” has been developed in the past decade that can effectively block the release of chemical triggers of inflammation. Biologics are taken with control medications to stop underlying biological responses which cause inflammation in the lungs. This therapy is an injection usually given about every two to four weeks. It typically takes several weeks/months to provide its benefit and needs to be given on a long term basis. When effective, the result is better asthma control, i.e., fewer exacerbations, improved daily symptoms and less need for oral steroids.

Xolair and Nucala are the brand names of the medications available for the past few years. Additional but very similar biologics, Fasenra and Dupixent, are also available. Side effects are generally minimal and well tolerated.

As you might imagine, all these medications are VERY expensive – without insurance it can cost anywhere between $1,000 to $3,000 per month. In my experience, most insurance carriers will cover the cost because of expected improved asthma control.

If you have difficult-to-manage asthma and think you might “fit the pro- file”, ask your health care provider whether you might be a candidate for a biologic therapy.

 

The FDA’s Arthritis Advisory Committee supports Ofev as a therapy for systemic sclerosis-associated interstitial lung disease (SSc-ILD), according to the Agency and manufacturer Boehringer Ingelheim. Currently marketed to treat idiopathic pulmonary fibrosis (IPF), nin- tedanib would become the first drug approved for SSc-ILD, a condition with few other options for treatment. SSc-ILD

is the leading cause of death in systemic sclerosis, also known as scleroderma, which affects multiple organ systems. About one in four people with SSc develops lung disease within three years of diagnosis. A study in the journal PLOS One, also found Ofev may be of benefit to those with Pulmonary Arterial Hypertension, by preventing cells of blood vessel walls from changing.