Cart 0

2nd part of "Biologics - the new treatment for severe asthma" looks at a further 4 treatments and how you can access them

Posted by Eamonn Brady on

Biologics for severe Asthma

New Asthma Treatment

Part 2


Biologics are a new class of drugs called monoclonal antibodies that are licenced for severe asthma. Last week I discussed Omalizumab (Xolair®), this week I discuss other biologics which include:

  • Mepolizumab (Nucala®)
  • Reslizumab (Cinqair®)
  • Benralizumab (Fasenra®)
  • Dupilumab (Dupixent®)


European Academy of Allergy and Clinical Immunology (EAACI) guidelines (continued)



Mepolizumab is an IL-5 inhibitor licenced as add-on therapy in adults and children over 6 with severe uncontrolled eosinophilic asthma. The EAACI strongly recommended Mepolizumab to limit exacerbations and taper oral corticosteroids in severe asthma but less strongly recommended it for less severe asthma in based on cost/ benefit analysis.


The EAACI strongly recommended Reslizumab as add-on treatment for adults with severe uncontrolled eosinophilic asthma who are taking controller medications to lower symptom exacerbations but less strongly recommended it for less severe asthma in based on cost/ benefit analysis.



Licenced as add on therapy for adults with severe eosinophilic uncontrolled asthma. Benralizumab is an IL-5 inhibitor. The EAACI strongly recommends Benralizumab as add-on therapy to reduce severe exacerbations and taper oral corticosteroids when the blood eosinophil count is >150/µL. The ECCAI less strongly recommended Benralizumab for other and less severe forms of asthma based on cost/ benefit analysis.


It is approved for severe asthma with type 2 inflammation characterized by raised blood eosinophils and/or raised fractional exhaled nitric oxide (FeNO); it is approved as add on therapy for adults and adolescents aged 12 to 17 years.

In early 2021, the indication of severe asthma was added to its licencing in Ireland (it was already licenced for severe atopic dermatitis) thus allowing it to be prescribed for this indication however, like the other biologics for asthma, it is not reimbursable under the HSE community drug schemes so not universally available to patients due to cost.

Dupilumab blocks two interleukin proteins called (IL-4 and IL-13) which differentiates it from the other biologic therapies; it has shown very favourable results in asthma trials. The EAACI strongly recommends it as add-on therapy to reduce symptom exacerbation and improve lung function and strongly recommended to reduce exacerbations, increase lung function, and taper oral corticosteroids in severe uncontrolled Type-2 asthma in over 12’s.

Availability of Biologics for Asthma in Ireland

Biologics in Ireland are not approved for use under the community drug schemes meaning they are not available via the DPS/ GMS schemes. In Ireland, biologics for asthma are paid for directly out of hospital budgets which limits availability as hospitals only have limited budgets.


Access to biologic therapy for patients is regulated by the HSE via a strict protocol which consultants must abide by; the cost of the drug is taken from their hospital’s allocated budget for biologics. This has led to a so called “post-code lottery” as access will vary and is largely dependent on individual hospital budgets.


Whilst mepolizumab and benralizumab are available in auto-injector pens to facilitate patient self-administration in other countries, these devices are not yet approved for use in Ireland, so biologic therapies must be administered by a specialist nurse in supervised settings in Ireland which further reduces patient access.


The Asthma Society of Ireland is leading a campaign for the Government to fund greater patient access to biologics.


Covid 19 Vaccine Clinic

Whelehans offer a weekly COVID-19 Walk in clinic at Whelehans Pearse St every Wednesday for Covid-19 boosters. Contact Whelehans Pearse St at 0449334591 or register on the Whelehans website.


For comprehensive and free health advice and information call in to Whelehans, log on to or dial 04493 34591 (Pearse St) or 04493 10266 (Clonmore). Email queries to Find us on Facebook.


Share this post

← Older Post Newer Post →