00:20
Speaker 2
New treatments and medications for asthma become available for patients every year, but it's important to talk to your doctor about what is right for you. I'm Tonya Winders, president and CEO of Allergy and asthma network and welcome to ask the allergist. In each episode we present a frequently asked question to a nationally respected allergist and they share their insight for this program. We're pleased to welcome doctor Rohit Katyal. Doctor Katyal is a board certified allergist and immunologist as well as Co director of the Asthma Institute. At National Jewish Health in Denver, colorado. He's also a member of the Board of Regents for the American College of Allergy, Asthma and Immunology. Welcome, Doctor Katyal good thank.
01:01
Speaker 1
You for being here today so our question today actually comes from a patient who says my asthma is worsening. I recently read about new biologic medications. How do they work and how will my doctor determine if biologics are right for me?
01:17
Speaker 1
So let me step back just for one moment. Asthma is a disease. Of inflammation of the breathing tubes and that inflammation is our immune cells coming into the airway causing them to get inflamed and then they get twitchy and narrow and we cough and mucus. And so that's what we traditionally see in asthma. So that's why in the past one of the main treatments and still continues to be is the inhaled steroids and they still are a great medication for many asthmatics, the new biologics that have now come to the market. Target chemicals that very specifically knockout the fuel or the gasoline or the energy for these immune cells, with the idea being that if we knockout the fuel then those cells no longer exist and therefore the airway doesn't get inflamed. There are expensive, there are injections that have to happen every month and so therefore we still use the inhalers as our primary treatment. But if you're an asthmatic who continues to have problems, is not responding or still doing well with the inhalers, then the next step now can be one of these biologics if you continue to have trouble with the asthma despite the traditional inhaler based medicines.
02:40
Speaker 2
So as you were talking about patients with those uncontrolled symptoms, perhaps they're taking an inhaled corticosteroid, perhaps they're on a combination Med, but they're still having uncontrolled symptoms and they're not doing very well. With their symptoms, with their severe asthma, would you recommend that they actually go in and talk to their allergist about the biologics and if so, also speak a little more about the administration routes of those biologics?
03:04
Speaker 1
So I absolutely recommend that they go seek care with an allergist, not only to discuss the new biologics, but first to go through what medications they've tried, how they've taken them, the technique, the inhaler, how long the doses. Assuming all that's been done, then now we have some exciting options. In addition, we've had one biologic, be aware for some years, omalizumab is an injectable biologic that blocks something called IG, right. So the antibody that causes allergy, as you know, there's two new ones called mepolizumab, these are long names and reslizumab. And these two both block the same chemical, got a long name called Interleukin 5 and that's the fuel for a cell called the Acinos Phils, and that's what drives the Airways. Breathing tubes to get inflamed. So the mepolizumab and reslizumab are two new biologics. The Mepolizumab is an injection like an allergy shot or like the omalizumab has been in the arm and the reslizumab is actually an intravenous infusion. So an IV has to be placed and the medication is delivered through the IV. But they both block the same chemicals and so they're these are very specific medicines. There are four severe asthma. But they're not for everyone, and that's where the allergists can play a role to define is this the right medication for you, for you to have to go through these monthly administrations? And they can look at whether you're allergic and if you have other triggers. So an allergy evaluation can be comprehensive, not only looking at what you've taken before, but really discussing the risks and the benefits and the pros cons of these new medications.
04:49
Speaker 2
Well, it's exciting to hear about these innovations and the new options for. Patients, thank you so much for sharing with us.
04:55
Speaker 1
Today, a pleasure.
04:56
Speaker 1
The mission at allergy and Asthma Network is to end needless death and suffering due to asthma, allergies and related conditions. We aim to do this through outreach, education, advocacy and research. Visit US online at allergyasthmanetwork.org for reliable resources. And don't forget to share this program with your family, friends and colleagues on behalf of allergy and asthma network. Thanks for watching and see you next time on ask the allergist.