Practical use of Ellipta, a once-daily, dry powder inhaler for children with asthma

Abstract

Patients with multiple allergic/immunologic diseases may require simultaneous biologic therapies. However, there is a paucity of literature regarding patient safety and outcomes while receiving dual biologic therapies. METHODS: A search of the electronic medical record was performed to identify patients over 18 years old treated with a biologic from our allergy, asthma, and immunology specialty clinics at 2 large urban hospitals, and a second biologic for any other indication within the last 10 years. The first biologic was required to be one commonly used in allergy and immunology practices (omalizumab, mepolizumab, benralizumab, reslizumab, dupilumab, canakinumab). Dual therapy was subcategorized into either a period of overlap (at least one dose of each biologic within 30 days), or ongoing therapy (simultaneous treatment with both biologics beyond 30 days). RESULTS: A total of 314 patients in our clinics have been treated with a biologic, 26 (8.3%) of whom received dual biologic therapy. Twelve patients received ongoing simultaneous biologic therapy while 14 had a period of overlap with a second biologic. Eleven of 12 patients receiving ongoing therapy had a positive clinical response to the ''allergy"-based biologic. Dual biologic therapy was not associated with serum sicknesslike reactions, infusion related or injection site reactions, or any other significant adverse reaction. There was no evidence of increased immune suppression or frequency of infections reported by patients. CONCLUSIONS: This report of patients on dual biologic therapy adds to the literature suggesting that dual biologics may not increase risk or impair clinical response.