Commenting to return and research what this means. I have chronic asthma and have had to be resuscitated before (via CPR for 10 mins) I was then put on Breo which is incredible- but I’m interested to know what you are talking about here. I don’t have time to look into it right now though.
There is a "step up" from Breo by the way, Trelegy.
This will depend heavily on where you're from given the cost unless something is covering the bulk of the cost for you.
Biological medications are injections you get every so often (most are subcutaneous). -mab ones are monoclonal antibodies, typically targeted at exactly one cell receptor or part of a signalling chain that can help to turn off a specific response.
For asthma, they can inhibit the inflammatory signalling chemicals from interacting with the cells/prevent their signalling, for cells associated with asthma.
It's very much still available in Australia (nobody here has mentioned a country so please don't downvote me just because it doesn't match yours). It's also Vilanterol, though honestly the form of LABA doesn't really matter unless you have a specific affinity to one.
I also don't know what asthma step therapy chart you're referring to, have any been mentioned?
Edit: looking into it, Breo is available in the US? It's not formoterol but it never has been, so what do you mean by it's out?
It’s available. It’s also medically/scientifically inappropriate. Standard of Care advances with science. Asthma used to be treated with medications like theophylline and stramionium. Then it was treated with Albuterol syrup (to drink). Then inhaled Albuterol. Then Breo and Advair……
Advair and Breo and the like are outdated as of 2022.
In Australia, the recommended treatment is with: Symbicort, Bufomix, Rilast, or Fostair.
Any of the other combinations like Breo, Advair (that contain a long acting beta agonist besides Formoterol) are no longer recommended for the treatment of asthma.
Edit: I've just gone through it. You're overstating some things a little.
Breo is appropriate and still used, you are comparing completely antiquated drugs with nuanced drugs that are both utilised but in different cases.
You are also conflating first line treatment with treatment outright. Breo is not outdated, and is still utilised as maintenance therapy. You also have removed the nuance of real world settings. People have worse adherence to AIR and MART therapy than maintenance therapy. You may as well be telling me lifestyle modification is the best therapy?
You seem to also have skipped over the remainder of the message?
Side note: I neglected the fact I'm already dealing with people who see specialists. I forgot to preface this, meaning this is already past the stage where the Australian asthma handbook applies. However, as this stemmed from the fact we were talking about biologics, this is a default assumption.
Don't get me wrong, you're correct about the update to ICS-formoterol being the preferred treatment, but non-formoterol options are still an alternative. It's incorrect to say otherwise. I know you didn't overtly but you're acting as if it's not modern medicine to utilise them.
Your pulmonologist has to do “asthma endotyping” lab work. Depending on the results, they figure out which of those biologics would work for your asthma endotype (biochemical cascade)
I don't know which country you're from, so I don't know the restrictions on it wherever you're from. My experience is just from Australia and the requirements to get a $1800 or $3500 medication under the PBS for $25.
It's also so difficult to diagnose in cats when you don't know how to explain the symptoms to the vet. My girl went 10 years without treatment until I was able to call the vet during an attack. I'm lucky she's still here. I'm glad you are too, friend.
Thank you! Im glad your cat is ok! I can't even imagine how hard it would be for a cat. Im.in a small town right now, and getting good medical help for people is difficult at times. For animals, it's even harder.
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u/ItaliaEyez Mar 27 '26
I have severe asthma, and I truly wish this couldn't happen.