What are biologic medications?
Biologics are precision medicines engineered from proteins that target specific molecules in the immune system. They block cytokines like IL-4, IL-5, IL-13, and IgE, or target receptors on mast cells and eosinophils, to interrupt inflammation at its source.
The eight biologics currently approved for allergic conditions are: omalizumab (Xolair), mepolizumab (Nucala), reslizumab (Cinqair), benralizumab (Fasenra), dupilumab (Dupixent), tezepelumab (Tezspire), tralokinumab (Adbry), and lebrikizumab (Ebglyss). There are two biosimilars Nemolizumap-ilto (Nemluvio) and Omalizumab-igec (Omlyclo)
Biologic medications have transformed care for chronic allergic and inflammatory diseases. They target the root cause of inflammation rather than just managing symptoms. This guide takes you from the basics to the latest trial data.
15 episodes · Patients, families & clinicians
Biologic Medications
Learn about biologics in 4 MODULES
Quick look
MODULE 1
What is a biologic?
New to biologic medications? Start here. These two episodes cover what biologics are, how they work at a molecular level, how they've evolved since 2003, and a full breakdown of eight currently approved for allergic conditions, which ones treat which diseases, and why some cover multiple conditions while others target just one.
Start here!
Ep. 83
What Is a Biologic Medication?
Dr. William Berger explains how biologic medications "zoom in" on specific immune pathways by targeting molecules like IgE, IL-4, IL-5, and IL-13. Instead of broadly suppressing the immune system. Covers how biologics are made, how they've evolved since 2003, and what patients should know before starting one. Kortney shares her own experience beginning biologic therapy.
Start here
Ep. 83
What Is a Biologic Medication?
Dr. William Berger explains how biologic medications "zoom in" on specific immune pathways by targeting molecules like IgE, IL-4, IL-5, and IL-13. Instead of broadly suppressing the immune system. Covers how biologics are made, how they've evolved since 2003, and what patients should know before starting one. Kortney shares her own experience beginning biologic therapy.
Start here
Ep. 87
What Biologic Therapies Are Available for Allergic Conditions?
Dr. Perdita Permaul walks through all eight approved biologics: omalizumab (Xolair), mepolizumab (Nucala), reslizumab (Cinqair), benralizumab (Fasenra), dupilumab (Dupixent), tezepelumab (Tezspire), tralokinumab (Adbry), and lebrikizumab (Ebglyss). Covers how each works, which conditions and age groups they're approved for, and why some biologics treat multiple diseases while others treat just one.
Start here
MODULE 2
Biologics by condition
The same biologic can treat multiple conditions. For example, dupilumab (Dupixent) covers asthma, eczema, CRSwNP, and EOE, while omalizumab (Xolair) covers asthma, chronic hives, CRSwNP, and food allergies. These episodes show how biologics are being used across specific conditions, including emerging options on the horizon.
Ep. 56
Asthma Treatments: Biologics
A deep dive into asthma biologics: omalizumab (Xolair), mepolizumab (Nucala), reslizumab (Cinqair), benralizumab (Fasenra), dupilumab (Dupixent), and tezepelumab (Tezspire). Learn how each works, who they help, and what to ask your doctor before starting one.
Ep. 82
Chronic Spontaneous Urticaria Treatments
Dr. Matthew Zirwas covers the next wave of CSU treatments from dupilumab (Dupixent, targeting IL-4/IL-13), omalizumab (Xolair), as well as remibrutinib (a BTK inhibitor blocking mast cell activation), and barzolvolimab (targeting the C-KIT receptor). Plus, he gets into the evolving understanding of CSU's autoimmune root cause.
Ep. 146
Chronic Rhinosinusitis with Nasal Polyps (CRSwNP)
A treatment-focused episode on CRSwNP covering nasal corticosteroids, saline irrigation, surgery, and biologics, including dupilumab (Dupixent), omalizumab (Xolair), mepolizumab (Nucala), and tezepelumab (Tezspire). What to expect from each, and when biologics become the right next step.
Ep. 98
Food Allergy Treatment and Management
Dr. Maya Gharfeh covers the full range of food allergy treatment options from strict avoidance to oral immunotherapy (OIT) and omalizumab (Xolair). Including what each involves, who they're suited for, and why none of them are cures. A practical overview of integrating these options into an allergy management plan.
Ep. 136
Food Allergy Treatments: What to Ask Your Doctor
Dr. Shahzad Mustafa on navigating today's food allergy treatment landscape: OIT versus omalizumab (Xolair), how to set realistic expectations, what questions to bring to your allergist, and why strict avoidance is still the right choice for some patients.
Understand the science
Why do so many biologics target Type 2 inflammation?
Most biologics for allergic conditions work by interrupting the Type 2 inflammatory pathway, the shared immune mechanism behind asthma, eczema, nasal polyps, and EOE. Our Type 2 inflammation guide explains the science.
MODULE 3
Biologic Trial Data: What the Studies Tell Us
The Itch Review is our journal club series. Dr. Gupta, Kortney, and Dr. Blaiss break down the landmark clinical trials behind the biologics that are changing care. Each episode includes a shareable infographic in the show notes.
Ep. 134
How Dupilumab Reduces Mucus Burden in Asthma: The VESTIGE Trial
The VESTIGE trial showed that dupilumab (Dupixent) significantly reduces mucus plugging in the airways of patients with asthma, an often-overlooked driver of poor lung function. Key findings on mucus score reduction, FEV1 improvement, and what this means for patients with type 2 asthma.
Ep. 109
Tezepelumab & Nasal Polyps: The WAYPOINT Phase III Trial
The WAYPOINT trial tested tezepelumab (Tezspire), which blocks TSLP upstream of the entire Type 2 inflammatory cascade, for adults with severe CRSwNP. Key outcomes: polyp score reduction, nasal congestion, loss of smell, and quality of life.
Ep. 129
Omalizumab for Multiple Food Allergies: The OUtMATCH Trial
The OUtMATCH Phase III trial tested omalizumab (Xolair) in patients with multiple food allergies, including peanut, tree nuts, egg, milk, and wheat. Key results: significant raising of reaction thresholds across multiple allergens, expanding treatment options beyond avoidance alone.
MODULE 4
Navigating biologic therapy
Starting a biologic is just the beginning. These episodes cover the practical realities from debunking common myths, getting through insurance, working with specialty pharmacies, and managing your medication when life doesn't stop for your treatment schedule.
Ep. 84
Biologic Medication Facts vs. Myths
Dr. Jamie Rutland tackles the most persistent myths: Do biologics suppress your immune system? Are they only for severe disease? Are they a cure? Can you use them alongside other medications? Can children use them? What's the real cancer risk?
Ep. 85
Navigating Biologic Therapy: What You Need to Know
Dr. Bill Anderson covers everything before, during, and after starting a biologic: prior authorizations, specialty pharmacies, co-pay programs, home injection versus clinic visits, vaccine considerations, missed doses, and how to know if your biologic is working. Kortney shares her own experience starting dupilumab (Dupixent).
Ep. 60
Can You Travel While on a Biologic Medication?
Yes — but it takes planning. Dr. Gupta and Kortney cover how to time doses around travel, cold-chain storage for biologics like dupilumab (Dupixent) and omalizumab (Xolair), what to pack, how to handle customs when traveling internationally, and what to do if your trip runs longer than expected.