Contraindications to the use of biologics in asthma

Paul O’Byrne

Are there any common contraindications to the use of biologics in asthma?

Paul O’Byrne: There have been, as yet, very few serious side effects with the biologics. There have been a few cases reported of an anaphylactic reaction with omalizumab, the anti-IgE monoclonal. It is a very rare event. So far, to my knowledge, there have not been any such reactions described with any of the anti-interleukin-5 monoclonals that I am aware of.

The main contraindication to the use of these drugs is their cost. They are very expensive and out of reach of most patients without the assistance of either the government funding or some insurance funding to help pay for them.

See also
  • Theophylline in COPD Should theophylline be abandoned in patients with chronic obstructive pulmonary disease? Even a recent study with low-dose theophylline on top of inhaled corticosteroids/long-acting beta-agonists has not shown any positive effects.
  • Biologic treatment in nonallergic asthma What biologic treatment – if any – is currently available for nonallergic asthma patients?
  • Asthma and ICSs in patients with chronic cough Asthma is thought to be one of the most common causes of chronic cough. After some basic diagnostic workup, is it reasonable to start a trial of inhaled corticosteroids in most patients? Or should each patient with suspected asthma undergo a bronchial provocation test or another specialist test?
  • Chest x-ray in asymptomatic elderly smokers Are there any potential benefits of performing and repeating chest x-rays in asymptomatic elderly smokers?
  • Asthma–COPD overlap syndrome A lecture by Prof. Paul O’Byrne, from McMaster University, Canada, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2016.

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