[Sponsored Article] The city has experienced several swift and sudden temperature drops this winter and they have troubled some people, especially those who suffer from asthma. At present, while many asthma patients depend on treatments such as inhaled corticosteroids and long-term controller medicines, a new group of medications called “biologics” has emerged that may considerably reduce patients’ dependence on traditional medicines. Asthma is a chronic inflammatory disease of the lower airways. As a heterogeneous disease, asthma severity varies greatly among patients as a result of different phenotypes. Patients with severe asthma are usually refractory to standard treatment. The poor symptom control has not only seriously affected their daily life, it can also pose itself as an increased risk of death to those patients. What is more, severe asthma generates a heavy financial burden to the health care system, society as well as individuals. Approximately 50-70% of uncontrolled asthma patients have type 2 asthma, which is characterized by type 2 inflammation, according to Dr. Raymond Tso, specialist in respiratory medicine. Type 2 inflammation is a specific type of immune response pattern that does have its positive side, such as eliminating parasitic infections. Excessive type 2 inflammation, however, can contribute to certain medical conditions such as eczema, allergic rhinosinusitis and some types of asthma. For specialists like Dr. Tso, asthma is increasingly considered to be part of a multimorbidity syndrome. A large proportion of asthma patients has reported symptoms of co-existing type 2 inflammatory diseases such as eczema, chronic rhinosinusitis with nasal polyposis and food allergies. Currently, the basic treatment that doctors usually prescribe to asthma patients includes inhaled corticosteroids and other long-term controller medicines that can be added if oral corticosteroids fail to control the patient’s asthma. Oral corticosteroids help to control inflammation. While experts advise that oral corticosteroids are for short-term use only, general practitioners may however prescribe them on a long-term basis for patients with frequent asthma flare-ups. It is not uncommon to see severe asthma patients combining quick-relief medicine, high-dose inhaled corticosteroids and long-acting bronchodilators. Of course most general practitioners are well aware of the fact that oral corticosteroids have the side effects of posing a risk to the function of other bodily organs. In fact, if an asthma patient’s symptoms are still not controlled after long-term use of an oral corticosteroid, a general practitioner should refer the patient to a specialist to see how other treatment options can be applied. Other options include a new group of medications called “biologics” which is one of the newest developments for the treatment of moderate to severe asthma. A biologic is a medication made from the cells of a living organism such as bacteria or mice which is then modified to target specific molecules in humans. For asthma, such targets are antibodies, inflammatory molecules or cell receptors. By targeting these molecules, biologics work to disrupt the pathways that lead to inflammation which are the causes of asthma symptoms. Biologics are now popular in the medical world but they have yet to be introduced to many of those who are suffering from asthma. Biologic medicines for severe asthma help block the response to airway triggers that cause inflammation, specifically targeting the cells that are part of the body’s immune system. Biologics can be delivered either by an injection in a doctor’s office, IV infusion in a clinic or hospital, or self-injection at home. To asthma patients, biological drugs can help reduce the need for steroids and thus can free them from the associated side effects of steroids. They can also reduce asthma attacks and asthma-related hospital admissions. That undoubtedly would mean a better quality of life for asthma patients. Biological treatment could be applied to patients with severe eosinophilic asthma and type 2 severe asthma, as well as those whose symptoms cannot be controlled by conventional treatments. As a matter of fact, biologics can serve as an add-on option and may not necessarily replace existing controller and reliever medications for an asthma patient. However, there are cases where patients can eventually reduce the dose of inhaled or oral corticosteroids. Recently, a 51-year old lady asthma patient, who used to be dependent on steroids, after 2 weeks of biologics treatment, experienced visible improvements from the symptoms which enable her to significantly reduce the dosage of previous medications. This article is supported by Sanofi Hong Kong Limited MAT-HK-2101301-1.0-12/2021
