[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › Biologics for asthma # Biologics for asthma Injected monoclonal antibodies that block IgE or type 2 cytokines (IL-5, IL-4/IL-13) in severe allergic or eosinophilic asthma. Updated Nov 1, 2026 ## What they are Asthma biologics are add-on treatments for severe asthma that stays uncontrolled despite high-dose inhaled corticosteroid plus a second controller. The choice follows the patient's phenotype: omalizumab (anti-IgE) for allergic asthma with raised IgE and a proven allergen; mepolizumab, reslizumab (anti-IL-5) and benralizumab (anti-IL-5 receptor) for eosinophilic asthma; dupilumab (anti-IL-4 receptor alpha, blocking IL-4 and IL-13) for type 2 asthma and atopic dermatitis; tezepelumab (anti-TSLP) for a broader range. They reduce exacerbations and the need for oral corticosteroids; they do not treat an acute attack. ## Mechanism of action Type 2 inflammation drives most severe asthma. Allergen-specific IgE sits on the high-affinity receptor (FcεRI) of mast cells and basophils and triggers their degranulation. IL-5 makes eosinophils mature, survive and enter the airway. IL-4 and IL-13 switch B cells to IgE, increase mucus and airway hyperresponsiveness. Each biologic removes one link: anti-IgE captures free IgE; anti-IL-5 antibodies starve eosinophils; anti-IL-4Rα blocks the receptor shared by IL-4 and IL-13. Target: IgE, IL-5 and the IL-4 receptor alpha chain (type 2 inflammation) ## Key points - Omalizumab = anti-IgE for allergic asthma; it also treats chronic spontaneous urticaria and nasal polyps. - Mepolizumab = anti-IL-5 for eosinophilic asthma, also EGPA and hypereosinophilic syndrome. - Dupilumab = anti-IL-4Rα (blocks IL-4 and IL-13): asthma, atopic dermatitis, nasal polyps; conjunctivitis is a typical side effect. - None of them treats an acute attack; inhaled corticosteroids are not stopped suddenly when a biologic starts. - Anaphylaxis can occur (boxed warning for omalizumab); helminth infections are treated before starting. ## Drugs in this class - [**Omalizumab** An anti-IgE antibody injected under the skin for severe allergic asthma, nasal polyps, chronic hives and food allergy… Immunoglobulin E (Fc region)](https://durgical.com/en/pharmacology/omalizumab/) - [**Mepolizumab** An anti-IL-5 antibody that lowers eosinophils, used in severe eosinophilic asthma, COPD, nasal polyps, EGPA and… Interleukin-5 (IL-5)](https://durgical.com/en/pharmacology/mepolizumab/) - [**Dupilumab** An antibody against the IL-4 receptor that blocks IL-4 and IL-13; used for atopic dermatitis, asthma, nasal polyps and… Interleukin-4 receptor alpha chain (IL-4Rα)](https://durgical.com/en/pharmacology/dupilumab/) - [**Benralizumab** An antibody against the IL-5 receptor that removes eosinophils, used as add-on treatment in severe eosinophilic asthma… Interleukin-5 receptor alpha chain (IL-5Rα)](https://durgical.com/en/pharmacology/benralizumab/) - [**Reslizumab** An anti-IL-5 antibody given by intravenous infusion as add-on treatment for severe eosinophilic asthma; anaphylaxis is… Interleukin-5 (IL-5)](https://durgical.com/en/pharmacology/reslizumab/) - [**Tezepelumab** An antibody against the epithelial alarmin TSLP, an add-on for severe asthma that also helps when eosinophils are not… Thymic stromal lymphopoietin (TSLP)](https://durgical.com/en/pharmacology/tezepelumab/) ## Others in the class - Benralizumab - Reslizumab - Tezepelumab ## Test yourself Think of the answer, then tap the question to see it. ## Which biologic binds free IgE? Omalizumab. ## Which cytokine do mepolizumab and reslizumab block, and which cell falls as a result? IL-5; blood and airway eosinophils fall. ## How does dupilumab block both IL-4 and IL-13? It binds IL-4 receptor alpha, the chain shared by the receptors for both cytokines. ## Can an asthma biologic be used to treat an acute attack? No: they reduce future exacerbations; an attack is treated with a short-acting bronchodilator and systemic corticosteroid. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/pharmacology/classes/biologics-for-asthma/) [More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology) [← All of pharmacology](https://durgical.com/en/pharmacology/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Omalizumab Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a603031.html) (MedlinePlus (U.S. National Library of Medicine), 2025); [Mepolizumab Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a615058.html) (MedlinePlus (U.S. National Library of Medicine), 2025); [Dupilumab Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a617021.html) (MedlinePlus (U.S. National Library of Medicine), 2025). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/classes/biologics-for-asthma/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/classes/biologics-for-asthma/