April 27, 2022

Treatment Options for Severe Allergies

Specialty Infusion Blog Derick

Allergies are a prevalent cause of diseases that can strike anyone. Allergies can be caused by various factors, including pollen, diet, and medicine, making it difficult to determine the proper home remedies and best treatments.

Treatment of Allergic Reactions

Home remedies and over-the-counter drugs are valuable options to prevent and treat many allergic reactions that can range from mild to severe. Different treatment options are available and commonly used to alleviate allergic symptoms. Treatment options for allergies and immunology continue to expand, thanks mainly to a medicine family known as biologics. These drugs, which are derived from living organisms, can target specific components of the immune system and prevent inflammation, which can cause several illnesses.

Biologics are monoclonal antibodies or drugs administered as a shot or as an IV infusion. They are blood proteins generated by humans. They are created by experts utilizing cells from living species. Biologics bind to components of your immune system that cause asthmatic inflammation and suppress it. Biologics reduce the precise, focused immune response, allowing asthma to be controlled without needing a broader immunosuppressive drug like prednisone, which has numerous adverse effects.

The following are the biologics used for the treatment of allergies.

Xolair (omalizumab)

The first and only biologic medicine to be authorized by the FDA was Xolair in 2003 to treat moderate-to-severe persistent allergic asthma.

Xolair is a prescription medication used to treat Allergic Asthma and Chronic Idiopathic Urticaria symptoms (CIU). Xolair can be taken alone or in combination with other drugs.

Xolair belongs to the Monoclonal Antibodies, Anti-asthmatics family of medicines.

The effectiveness and safety of Xolair is unclear in children under six.

Suspension culture of Chinese hamster ovary cells in a nutritional medium with the antibiotic gentamicin leads to the production of Xolair. The presence of gentamicin in the finished product is undetectable. Xolair is given as a subcutaneous injection (SC) in a single-use vial of sterile, white, preservative-free lyophilized powder reconstituted with Sterile Water for Injection (SWFI) USP.

XOLAIR is mainly prescribed for adults and children aged 6 and up who have moderate to severe persistent asthma, also indicated in those individuals where symptoms are not managed well with inhaled corticosteroids. Moreover, in people who have a positive skin test or in vitro reactivity to a perennial aeroallergen.

Individuals with chronic idiopathic urticaria or adults and adolescents 12 years of age who remain symptomatic despite H1 antihistamine therapy should take Xolair.

Dupixent (dupilumab)

Dupixent is a member of the class of drugs known as monoclonal antibodies. These medications target a particular area of the immune system.

The available forms of Dupixent in the market include prefilled single-dose syringes and pens. It is administered with a subcutaneous injection (under your skin). Dupixent is available in two doses: 200 mg/1.14 mL and 300 mg/2 mL solutions.

When topical treatments for atopic dermatitis are insufficient or inappropriate, Dupixent can be prescribed to patients aged 12 and up with mild to severe atopic dermatitis. If the patient’s condition is serious, the drug can also be administered to children aged 6 to 1. In individuals 6 years or older whose asthma is not well controlled by a combination of medications, Dupixent can be prescribed for maintenance treatment for severe asthma and when a combination of medicines does not control asthma well. Dupixent is exclusively prescribed for individuals who have a kind of airway inflammation known as ‘type 2 inflammation.’

Nucala (mepolizumab)

Mepolizumab is a first-in-class monoclonal antibody that targets IL-5 that was authorized in 2015 for chronic eosinophilic asthma. It reduces blood eosinophils without eliminating them by inhibiting IL-5 from attaching to its receptor on the surface of eosinophils.

Mepolizumab is a drug designed and sold under the brand name Nucala in the US, Europe, and over 20 other markets as an add-on maintenance medication for patients with severe eosinophilic asthma to treat disorders associated with eosinophil inflammation. It has been examined in over 3,000 patients in 21 clinical trials spanning a variety of eosinophilic indications (SEA). In Europe and the United States, it is licensed to treat severe eosinophilic asthma in children aged six to seventeen.

It is mainly used for polyangiitis therapy for elderly patients with eosinophilic granulomatosis.

It can also be used for the treatment of hypereosinophilic syndrome (HES) in adults and children aged 12 and above for 6 months without an identified non-hematologic secondary cause.

In individuals 18 years and older, it is prescribed as maintenance therapy for chronic rhinosinusitis with nasal polyps (CRSwNP) for those who have not responded to nasal corticosteroids.

Fasenra (benralizumab)

The FDA approved FASENRA in 2017. It is a biologic that may help individuals with severe eosinophilic asthma who have not shown improvement with existing prescription drugs. FASENRA is an asthma medication used to treat individuals with eosinophilic asthma. Eosinophils are white blood cells that help the immune system fight diseases and parasites.

FASENRA is the first and only respiratory biologic to incorporate Q8W maintenance dosing with at-home or in-office administration choices, resulting in the minimum injections per year for patients. The prefilled syringes and prefilled pens of FASENRA are available as a solution for injection. However, it must be sold on a prescription, and physicians with expertise in diagnosing and treating severe asthma should begin therapy.

The suggested dosage is 30 mg injected beneath the skin of the thighs or abdomen once every four weeks for the first three doses and once every eight weeks after that. The injection must be injected beneath the skin of the upper arm if delivered by a doctor or caregiver.  It’s used to supplement a combination of high-dose inhaled corticosteroids and drugs known as long-acting beta-agonists in individuals with severe asthma who aren’t getting enough relief. The active ingredient in FASENRA is Benralizumab.

FASENRA should only be used under the supervision of a medical expert. In addition, patients should be monitored after receiving biological medicines, as advised by clinical practice. After getting suitable training in subcutaneous injection techniques and a healthcare practitioner certifying that it is acceptable, patients/caregivers may use the FASENRA Pen.