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BIOLOGIC TREATMENTS FOR ASTHMA PATIENT INFORMATION THIS IS MODERN MEDICINE

BIOLOGIC TREATMENTS FOR ASTHMA PATIENT INFORMATION What Are Biologic Treatments For Asthma Biologic treatments used for asthma are also known as monoclonal antibodies or mAbs These are specialist treatments which use antibodies produced from cells in a laboratory to target specific cells within the body Monoclonal antibodies can treat some types of severe asthma by helping to stop body processes that cause lung inflammation This is inflammation which may be caused by allergies or by high levels of a cell in the body called an eosinophil Monoclonal antibodies are a very specialist targeted treatment They are expensive and strict criteria is in place as to who can access them Most monoclonal antibodies are given as an injection either in clinic or using pre filled syringes at home Reslizumab is given through an intravenous drip What Is An Eosinophil Eosinophils are a type of white blood cell linked to inflammation People with severe asthma sometimes have high levels of eosinophils in the blood This can be shown with a blood test called an eosinophil count which calculates the number of eosinophils in your blood Eosinophil levels are important to help specialist asthma clinics decide what type of asthma you have They help determine what treatments including biologics will work for you best How Do They Treat Asthma Biologic treatments are only available for certain types of severe asthma which are not well controlled with high doses of steroid inhalers Severe Allergic Asthma Occurs when severe symptoms are triggered by allergies This type of asthma mostly starts in childhood Omalizumab is a biologic that targets severe allergic asthma by reducing the allergic response Eosinophilic Asthma Occurs when severe symptoms are triggered by higher levels of cells called eosinophils This type of asthma is usually associated with adult onset asthma Mepolizumab reslizumab and benralizumab are all biologics that target severe eosinophilic asthma by reducing eosinophils Severe Asthma with Type 2 Inflammation Occurs when severe asthma symptoms are driven by both allergies and high levels of eosinophils Dupilumab is a biologic targeting severe type 2 inflammatory asthma It works by damping down the inflammatory response All types of severe and uncontrolled asthma Tezepelumab has been found to work across all types of severe and uncontrolled asthma It works on inflammation and reduces airway responsiveness or twitchiness which means it can stop airways reacting so much to triggers Unlike other biologics people with severe asthma can access Tezepelumab without the need for specific biomarkers such as eosinophil count or allergy status

What Are The Benefits Of Biologics Biologic treatments can Lower the risk from eosinophilic asthma or severe allergic asthma Allow patients to reduce the dose of their oral steroids and lower the risk of side e ects from these They also help those with severe asthma to manage their symptoms and reduce asthma attacks Keep Taking Your Usual Asthma Medicines Never reduce or stop taking steroid medicine for asthma without speaking to your doctor If you have been told to reduce your steroid tablets after starting biologics this must always be done gradually with support and guidance from your doctor Risks And Side E ects Of Biologics As with all medicines biologic treatments can have risks and side e ects Common Side E ects Some common side e ects Headache Sinus pain Sore throat Soreness at the injection site this should pass in a few days and may improve after you have had the injection a few times It is important that you recognise the common signs and symptoms of a reaction Reactions should be reported to your doctor or nurse immediately if they occur after you have left the clinic Always talk to your doctor or specialist team if you are concerned about any of these risks or side e ects Severe Allergic Reactions Biologic treatments for asthma have an increased risk of a severe allergic reaction anaphylaxis The risk is rare 1 in 1 000 and more likely if you have a history of allergic reactions or anaphylaxis You may be asked to stay in the clinic for a short time after your first few treatments This is so your healthcare team can make sure you are not at risk of an extreme allergic reaction For your first few injection visits it may be best if someone can accompany you to the clinic so you don t have to drive afterwards

Signs of an allergic reaction include Itching trouble breathing wheezing fever shivering dizziness headache nausea vomiting abdominal discomfort skin rash redness or swelling Parasitic Infections Biologics can in rare circumstances make you less resistant to parasitic infections such as cyclospora intestinal worms or malaria This means your body cannot fight o infections like these so well Get advice from your doctor if you are travelling to regions in the world where parasitic infections are more common than they are here in Ireland To start the assessment for biologic treatments you will need to have been reviewed by a Respiratory Consultant How Soon Can You Start Using Biologics It is not always easy to access biologic treatments A lot depends on how well you have been sticking to your current medications and also can depend on any other conditions you may have Going To The Asthma Nurse Clinic You will need to attend a specialist asthma clinic in order to start biologics treatment This clinic is run by a Respiratory Clinical Nurse Specialist along with their respiratory nurse team and is located within Beacon Hospital It is advised that you attend three clinic appointments prior to commencing your biologic therapy You must attend a fourth clinic visit after completing 12 months of your biologic therapy The Specialist Asthma Clinic involves the following Assessment of your symptoms Assessment of your inhaler technique Adherence with your medication FeNo assessment breathing test Spirometry Peak flow monitoring Providing Spirometry device and education Personalised asthma action plan Eosinophil levels blood tests

Attending The Infusion Suite For Your Biologic Infusion The Biologic therapy Reslizumab is suitable for adults aged 18 and over It is given as an intravenous infusion This means you will be put onto a drip so the medicine can administer slowly into a vein You will be scheduled to attend the Infusion Suite This is located in the Green Mall adjacent to the main Beacon Hospital building You will have this infusion every 4 weeks over a 12 month period The nurses in the infusion suite will schedule your appointment days and times If you have an acute asthma exacerbation in between doses please contact your Respiratory Nurse Specialist Respiratory Consultant or the Infusion Suite directly If you have had to commence antibiotics for a non respiratory related illness please contact your Respiratory Nurse Specialist or Respiratory Consultant to let them know You will not be able to receive your Reslizumab if you are on antibiotics at the time of your scheduled infusion Reviewing Treatment You will need to review your treatment regularly This could be every six months and at least yearly It may take three to four months to see any improvement Your specialist may use tests to see how you are getting on Tests may include spirometry FeNO and blood tests You may also be asked to complete an Asthma Control Test ACT questionnaire If the treatment is not working for you or you are experiencing unpleasant side e ects your specialist may decide to stop treatment and to consider other options It is important to contact your healthcare team if your asthma symptoms are not improving or are getting worse Do not stop taking either your usual asthma medicines or your biologic treatment unless your doctor tells you to Stopping or interrupting treatment could make your symptoms come back If your asthma improves with the biologic treatment you can continue it and review again in 12 months You may be able to reduce the long term steroid tablets you are taking for your asthma If your asthma does not improve with biologic treatment you will need to stop the treatment and consider other options You may require further investigations to confirm which type of asthma you have

Your Journey Asthma Biologic Therapy Your Respiratory Consultant has referred you for Reslizumab an Asthma Biologic Therapy What happens next 1 Initial Respiratory Consultant Review Asthma biological treatment Relizumab has been chosen as an additional therapy Asthma Nurse Clinic 2 3 visits to be completed prior to starting your Reslizumab These will take place over an 8 12 week period Infusion Suite 3 Reslizumab will be given in the infusion suite every 4 weeks for 12 months Asthma Nurse phone assessment prior to each infusion 4 Asthma Nurse Clinic 4th visit at 12 months 5 Respiratory Consultant Review 12 month review with your Respiratory Consultant Cost Your Reslizumab infusions should be covered by your Private Health Insurance Please contact your provider directly to ensure you are covered for this treatment Nurse Asthma Clinic Nurse Asthma Clinic visits as outlined above Total cost 550 for 4 clinic visits This cost is to be paid privately and is not currently covered by private health insurance Any Further Queries Please Contact Respiratory Clinical Nurse Specialist 087 953 2610 Respiratory Liaison Nurse 087 068 6645 Infusion Suite 01 293 4846 Main Reception 01 293 6600

Beacon Hospital Sandyford Dublin 18 D18 AK68 Tel 01 293 6600 www beaconhospital ie Version 1 08 2024