What is a Biologic?

Biologics (and biosimilars) are antibodies and similar proteins developed against specific targets important in inflammation. This includes receptor antagonists and cytokine / chemokine receptors.

Biologics have been developed through many years of lab research on different aspects of the immune system. They have been brought into clinical use in Canada since the late 1990s for many chronic diseases such as rheumatoid arthritis and other connective tissue disorders, inflammatory bowel disease, and some eye diseases. It has also been used for certain cancer therapies.

Biologics for Severe Asthma:

The first biologic introduced for severe asthma in Canada was omalizumab (Xolair®) in 2005.

Since 2014, 3 new biologic treatments, all in the class of “anti-IL-5 agents”, have come into clinical use in Canada. Interleukin-5 (IL-5) is important for the development and maturation of eosinophils, a type of white blood cell important in asthma, allergies – and fighting off parasite infections.

Mepolizumab (Nucala®)
Reslizumab (Cinquair®)
Benralizumab (Fasenra®)

Newer agents are likely to come into the Canadian market in the near future, including Dupilumab, an anti-IL-4 agent.

Like other medications and inhalers brought into the Canadian market, they first need approval through Health Canada and its subsidiary branch CADTH (Canadian Agency for Drugs and Technologies in Health).

How do Biologics Work?

Biologics work through modifying the immune system (immune modulators). Like other medication, immune modulation has both good and bad effects.

Therefore before initiating therapies with these agents a careful review of appropriateness of use would be important.

To learn more about biologics:
Fajt, M. L., & Wenzel, S. E. (2017). Development of new therapies for severe asthma. Allergy, asthma & immunology research9(1), 3-14.
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