Learn about Biological Medications

What are Biological Medications?

Many medications are produced in a laboratory using a chemical process – they are small molecules and aim to relieve the symptoms you are experiencing, but they do not treat the underlying cause of your health issue.  Their structure is simple and easily identified. Biological medications go deeper – they treat your health concern by focusing on specific cells, proteins and pathways.  They are grown in a laboratory from living organisms such as humans, animals or microorganisms.  They are large and complex medications at the forefront of drug research. New Biological medications are constantly being developed.

What can a Biological Medication do for me?

For patients with conditions such as severe asthma, atopic dermatitis, nasal polyps, or chronic spontaneous urticaria, Biologicals can “turn off” parts of the immune system that significantly contribute to inflammation. This leads to less symptoms, improved function, and often an improved quality of life.

In disorders such as primary immunodeficiencies or hereditary angioedema, Biologicals can replace the missing pieces of the immune system or disrupt overactive pathways. Whatever the condition, Biologicals act on specific targets rather than a generalized immunosuppression similar to how corticosteroids work. 

The more specific the target, the less risk for long-term side effects.

What is treatment with a Biological medication like?

Biological medications are usually used when other treatments aren’t working and they target specific cells to prevent symptoms from occurring – they don’t just treat the symptoms to relieve discomfort.  The medication is given by injection, usually in the doctor’s office or clinic.

These medications do not offer immediate relief;  it takes time for the effects of the medications to be felt and there may be side effects of the different medications.  In some cases, more than one biological medication may need to be tried to find the right treatment for an individual patient.

What Biological medications are used for allergy and airway health issues?

(Please check to see which medications are approved in your country)

There is a growing list of biological medications that are available for use for allergy and airways health issues.  Some can target more than one health issue and are listed in more than one category.

Below is the mechanism of action for several approved Biological medications (prescribing information depends on the country you live in):

  • Benralizumab (Fasenra) – Used to treat eosinophilic asthma.
    • Medication target: IL-5 receptors involved in the regulation of eosinophils.
  • Tezepelumab-ekko (Tezspire) – Treats severe asthma.
    • Medication target: TSLP, a key epithelial cytokine.
  • Mepolizumab (Nucala) – Treats eosinophilic asthma that is not controlled by other asthma medications.
    • Medication target: IL-5 protein,  a cytokine responsible for regulating eosinophils.
  • Omalizumab (Xolair) – Treats moderate-to-severe persistent allergic asthma.  Also used to treat chronic urticaria (hives).
    • Medication target: Prevents IgE from binding to IgE receptors on mast cells & basophils.
  • Dupilumab (Dupixent) – Treats two of the key sources of Type 2 inflammation to help improve asthma symptoms 
    • Medication target: Targets IL-4 and IL-13 signaling, two of the key drivers of local and systemic type 2 inflammation.
  • Reslizumab (Cinqair) – Used to treat severe asthma.
    • Medication target: IL-5 receptors, reduces growth or proliferation of eosinophils.
  • Dupilumab (Dupixent) – Treats moderate-to-severe atopic dermatitis (eczema) that does not respond well to other prescription topical therapies.
    • Medication target: an antibody that binds to IL-4 receptor alpha chain and blocks the signaling of two key inflammation cytokines, IL-4 and IL-13.
  • Tralokinumab- ldrm – (Adbry) – For treatment of severe atopic dermatitis.
    • Medication target: Blocks the inflammatory cytokine  IL-13 signaling.
  • Omalizumab (Xolair) – Treats moderate-to-severe persistent allergic asthma.  Also used to treat chronic urticaria (hives).
    • Medication target: Prevents IgE from binding to IgE receptors on mast cells & basophil:  immune cells involved in the allergic response.
  • Quilizumab – Used in treatment of allergic asthma and chronic urticaria.
    • Medication target: IgE – blocks the allergic response.
  • Dupilumab (Dupixent) – Treats moderate-to-severe atopic dermatitis (eczema) that does not respond well to other prescription topical therapies and nasal polyps.
    • Medication target: IL-4 receptor alpha chain.
  • Mepolizumab (Nucala) – For patients who have eosinophilic asthma that is not controlled by other asthma medications.  Can also be used to treat chronic rhinosinusitis with nasal polyps (CRwNP).
  • Medication target: IL-5 receptors involved in the regulation of eosinophils.

Treatments for HAE include plasma-derived and recombinant C1-INH, recombinant new proteins and monoclonal antibodies (as ecallantide, lanadelumab and monoclonal antibodies blocking FXIIa) as well as synthetic peptides and small molecules (as icatibant, BCX 7353 and KVD900). The therapeutic options for children have recently widened and include not only pdC1-INH but also icatibant.

  • Immunoglobulin subcutaneous (CutaQuig) – Treats adults and children who have primary immunodeficiency (PI).
    • This medication contains immunoglobulin G (IgG) that helps fight infection. It is infused under the skin.
    • There are many forms of this medication that can be given intravenously as well.
  • Dupilumab (Dupixent) – Is approved for EoE and treats moderate-to-severe atopic dermatitis (eczema) that does not respond well to other prescription topical therapies.
    • Medication target: an antibody that binds to IL-4 receptor alpha chain and blocks the signaling of two key inflammation cytokines, IL-4 and IL-13.
  • Omalizumab (Xolair) – Currently under investigation by the FDA for management of food allergy.

Are there Biological medications for COPD?

We will see more biological medications developed all of the time. There are currently six different biologicals being studied in Phase III trials in COPD clinical programmes around the world.  Watch for them to become available in your region.

What words do you need to know when talking about Biological medications?

Important words or phrases to know when discussing Biological medications:

  • Biological product – used to prevent and treat diseases and health issues.  They are a diverse category of products produced from a living organism (human cells, animal cells or microorganisms).
  • Biosimilar medication – A highly similar copy of a biologic medication with a similar action but produced at a lower cost.
  • Cells – the smallest unit that can live on its own and make up living organisms.  The “building blocks” of living things.
  • Chemical process – a method of converting the composition and structure of one substance into another.
  • Eosinophils – a type of immune cells that has small particles with enzymes that are released during infections, allergic reactions and asthma.
  • Immune system – a complex network of cells, tissues or organs that help the body fight infections and disease.
  • Living organism – a living thing that has an organized structure and can react to stimuli, reproduce, grow, adapt and maintain life.
  • Treatment – The management and care of a patient to prevent or manage a health condition.

What if I have two or more health issues that would benefit from a biological medication?

While some biological medications can treat more than one health concern, you can be treated with a combination of biological medications when necessary.  It’s important to talk to your doctor about all of your health issues so the best unique medical treatment can be developed for you.

Biological medications treat specific issues at their source – at the cellular level.  If you needed to treat more than one issue, more than one biological medication could be prescribed by your doctor to be sure to help you treat all of your symptoms.

Are Biological medications expensive?

Biological medications are expensive.  Why?  It is a complex process to produce these advanced medications and that is reflected in the cost of the medications.  The products are the result of extensive research with few competitors at this time.

What are the differences between a Biological medication and a Biosimilar one?

A Biosimilar medication is not identical to a Biological medication, but its structure and action are very close to the original medication.  The Biosimilar medication is less expensive while it is usually very closely related to the original Biologic.  They will both have a similar action and use. Feel free to discuss both options with your doctor if available. 

Is a Biological medication for me?

It’s important to weigh several factors when considering Biological medication:

  • What treatments have I already tried?
  • Do I need to change what I’m doing?
  • Am I willing to have injections at my doctor’s office on a regular basis?
  • What will the medication cost?

It’s important to discuss Biological medications with your doctor to be sure that this is right for you.  Check out our “Discuss” page to look at practical strategies for talking to your doctor about a Biological medication.

Learn

  • What words do you need to know?
  • What Biological medications are used for allergy and airway health issues?
  • Are Biological medications expensive?
  • What is treatment with a Biological medication like?
  • What should I consider when thinking about a Biological medication?
Learn More >

Discuss

  • What questions do I want to ask my doctor or healthcare provider?
  • What is shared decision making?
  • How do my doctor and I find the right Biological medication for me?
Learn More >

Take Action

  • How do I prepare for treatment with a Biological medication?
  • What resources are available for me as I move forward with a Biological medication?
  • What should I expect from treatment with a Biological medication?
Learn More >

Based in Vienna, Austria, GAAPP’s Board is representative of all regions of the world with large and small groups, all with a common purpose: empowering the patient and supporting the patient voice so that decision-makers in both the public and private sectors in government and industry will be mindful of patient needs, patient desires, and patient rights.

Since 2009 we have grown into a vibrant worldwide organization with more than 60 constituent members from every continent sharing information and best practices, concerns, and hopes.

It is not the policy of Global Allergy & Airways Patient Platform to recommend or endorse any product or treatment.

It is part of the role of GAAPP to provide information on a wide range of products and treatments to keep those with allergy & airways issues as fully informed as possible as to all options available. For medical advice, consult your health professional.

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