Secure online access to Cleveland Clinic's specialists for over 1,200 medical diagnoses, nutritional consultation and pre-adoption advice

Cleveland Clinic News  The latest from our experts

Is Your Asthma Severe? Here’s a New Treatment (When Steroids Fail)


Biologics for AsthmaMany people with asthma control their symptoms with regular use of medications for inflamed airways.

But what if you have severe asthma that doesn’t respond to these drugs, including corticosteroid inhalers or anti-inflammatory pills, such as montelukast?

You may consider biologics, a newer, different type of drug for treating eosinophilic asthma.

Why some asthma is harder to treat
If you have asthma, inflammation in your breathing tubes may cause coughing and excess mucus in your airways. And, you know the typical symptoms — wheezing and shortness of breath.

Underlying problems like allergies can worsen some types of asthma. In these cases, avoiding allergens and being on asthma medications (inhaled steroids) can help reduce the inflammation. In severe asthma, a biologic specific for neutralizing allergic triggers, Omalizumab, may be needed.

Omalizumab has been available for 10 years, is an injection, and neutralizes some of the effects of allergies on severe asthma. In contrast, mepolizumab and reslizumab concentrate on targeting eosinophils, whether or not allergies are involved.

Eosinophilic non-allergic asthma is different. The eosinophil, a type of white blood cell, causes this type of asthma even without the involvement of allergies.

These blood cells are useful in the right amounts; they help your body fight off disease. But when there are too many in your airways, they can lead to severe asthma.

This type of asthma can even begin in adulthood. A doctor can identify eosinophilic asthma by testing your blood or mucus for eosinophils. Steroids by mouth may help, but people often need high doses, which can cause severe side effects.


How can biologics help?