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How do Nucala. Xolair, and Cinqair work to improve asthma control?

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Mepolizumab (Nucala) is a biologic therapy that controls the blood cells that often trigger asthma. Nucala targets Interluken-5 (IL-5) which regulates the levels of blood eosinophils (the type of white blood cells that helps trigger asthma). Genetically engineered, Nucala keeps IL-5 from binding to eosinophils and, thereby, lowers the risk of a severe asthma attack.

Nucala is administered by injection once every 4 weeks and is meant to be used in conjunction with other asthma treatments as a maintenance medication. By using Nucala, patients have been found to not only experience fewer asthma incidents, but they are able to reduce the amount of their other asthma medications. Side effects include headache and a hypersensitivity reaction that can cause swelling of the face and tongue, dizziness, hives, and breathing problems.

Omalizumab (Xolair), an immunomodulator, works differently from other anti-inflammatory medications for asthma . Xolair blocks the activity of IgE (a protein that is overproduced in people with allergies) before it can lead to asthma attacks. Immunomodulator treatment has been shown to help reduce the number of asthma attacks in people with moderate to severe allergic asthma whose symptoms are not controlled with inhaled steroids.

Xolair, a prescription maintenance medication, is given by injection every 2 to 4 weeks. It's recommended for people with moderate to severe allergic asthma. Side effects may include redness, pain, swelling, bruising or itching at the injection site, joint pain, and tiredness. There is a slight increase in risk for problems with the heart and circulation to the brain in people using Xolair. It also carries a boxed warning about a severe, potentially life-threatening allergic reaction called anaphylaxis.

Reslizumab (Cinqair) is another maintenance medication. It is used along with regular asthma medicines when those medicines cannot fully control your asthma. This medicine is given every 4 weeks as an intravenous injection over a period of about an hour. This drug works by reducing the number of a specific type of white blood cells called eosinophils that play a role in causing asthma symptoms. It can reduce severe asthma attacks. Side effects include anaphylaxis (a severe allergic reaction), muscle pain, and cancer.

SOURCES:

American Academy of Allergy, Asthma & Immunology: "Asthma Medications."

American Lung Association: "Long-Term Control Medications."

Asthma and Allergy Foundation of America: "Non-Allergic Asthma."

Boehringer Ingelheim: "US FDA Expands Approval of Tiotropium Respimat® for Maintenance Treatment of Asthma in Children."

FDA News Release. “FDA approves Cinqair to treat severe asthma.”

FDA. Prescribing Information: Spiriva Respimat.

News release, Merck.

News release, GlaxoSmithKline.

NIH, MedlinePlus: "Omalizumab Injection."

 

Reviewed by Carol DerSarkissian on August 11, 2019

SOURCES:

American Academy of Allergy, Asthma & Immunology: "Asthma Medications."

American Lung Association: "Long-Term Control Medications."

Asthma and Allergy Foundation of America: "Non-Allergic Asthma."

Boehringer Ingelheim: "US FDA Expands Approval of Tiotropium Respimat® for Maintenance Treatment of Asthma in Children."

FDA News Release. “FDA approves Cinqair to treat severe asthma.”

FDA. Prescribing Information: Spiriva Respimat.

News release, Merck.

News release, GlaxoSmithKline.

NIH, MedlinePlus: "Omalizumab Injection."

 

Reviewed by Carol DerSarkissian on August 11, 2019

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