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Conversations in Pulmonary, Critical Care and Sleep Medicine by the American Thoracic Society
Speaker 1: You're listening to
the ATS breathe easy podcast
brought to you by the American
Thoracic Society.
Speaker 2: Hello, and welcome.
You're listening to ATS Breathe
Easy with me, your host, doctor
Amy Attaway. Each Tuesday of
every month, the ATS will
welcome guests who will share
the latest in pulmonary critical
care and sleep medicine. Whether
you're a patient, patient
advocate, or health care
professional, the ATS Breathe
Easy podcast is here for you.
Joining me today are two people
who have strong ties to the
American Thoracic Society,
doctor Monica Craft and doctor
Didi Gardner.
Doctor Craft is a former
president of the American
Thoracic Society and the Marie m
Rosenberg professor and system
chair, department of medicine at
the Icahn School of Medicine at
Mount Sinai. Doctor Gardner is
chief research officer of the
Asthma and Allergy Network and a
member of the Public Advisory
Roundtable, which integrates the
patient perspective into ATS
programs and activities like
today's podcasts. Welcome to you
both. So for this episode, we
wanted to focus on an issue that
a lot of clinicians deal with,
which is dealing with asthma and
then biologics in the context of
treating asthma. Doctor Monica
Craft is an expert on many
things, and we are so fortunate
that she's going to spend her
time and expertise discussing
this, podcast, which is going to
be on asthma and biologics.
So doctor Kraft, again, we are
so excited to have your
expertise today. And I think one
of the things we wanted to start
with was maybe you could talk
about what is a biologic.
Speaker 1: Well, thank you.
Thank you so much, Amy, for and
the ATS for having me today.
It's exciting. You know I love
the ATS. Special it's a special
place in my heart.
And so, of course, talking about
asthma is another topic I I I
know very well. And, you know,
biologics have been a very
exciting aspect to asthma care,
so I'm really excited that we
get to talk about them today.
And and a biologic is really
something that comes from a
living thing, like a bacteria, a
plant, a cell, and and it
targets a certain receptor or
pathway of inflammation. In this
case, it's the lung. You might
have heard of Humira for
rheumatoid arthritis,
entanercept.
Those are biologics for other
diseases. We happen to have six
biologics to treat asthma
because the the understanding of
the immunology of of asthma has
exploded over the last couple of
decades, and that has allowed
the development of these
treatments that target these
specific receptors on cells and
pathways. And and and we can we
have them in our armamentarium
now to treat our patients with
severe asthma. So I'm really
happy about that.
Speaker 2: Yes. I would say, it
has really revolutionized.
Biologics have revolutionized
how we treat asthma. And so I
think, as you mentioned, there's
six different ones. So we wanted
to really get your perspective
on what factors guide your
selection of a specific biologic
for a particular patient for
their asthma.
Speaker 1: Sure. Absolutely. So
I take care of patients with
asthma across the spectrum as
well as COPD and other limb
diseases. But when it comes to
severe asthma, I start thinking
about a biologic when I'm seeing
a patient who's already really
maximized with inhaler therapy.
So they're on very good
inhalers, like an inhaled
steroid, and a long acting beta
agonist or a long acting
albuterol.
Usually, it's in one device, and
they're using that and they're
very adherent. They may be on a
a a second inhaler, which is
like a, like a t atroprium,
something like that, that's a
long acting muscarinic
antagonist that's also a
bronchodilator, or it could be a
controller like montelukast,
something else. So they're
usually on at least three
controllers. And you and, you
know, I've had conversations
with patients. They've been
adherent.
They know how to use these
medications. And they're still
having trouble with asthma,
mainly asthma attacks, meaning
attacks that result in very
acute onset, shortness of
breath, wheeze, cough that
require emergency room visits,
urgent care, sometimes
hospitalizations, and,
ultimately, oral or IV steroids.
So those are those are really
concerning events. And so when
those when patients experience
those and I would say, you know,
twice a year for sure, but even
once a year, in my opinion, is
is not ideal. But twice a year,
yes.
And in some countries, it takes
actually four times a year to
qualify for a biologic. But in
The US, we start thinking about
it maybe once or twice a year.
Then, that's one of the the the
features. We also wanna make
sure that, additional processes
that are going on with them have
been addressed that can actually
add to medication burden and
asthma, like allergic rhinitis.
Are they taking care of their
sinuses in terms of their if
they have an allergic component
to their asthma?
Are they using nasal steroids?
Things like that to really help
with the rhinitis. Do they have
heartburn, gastroesophageal
reflux disease? We know that
just having acid in the
esophagus can trigger a nerve
that causes the airways to
constrict. So we definitely
wanna take GERD or reflux off
the table.
So is that being treated
appropriately? Do they need a
gastrointestinal GI evaluation?
Do they have obstructive sleep
apnea? It's another process that
can actually add medication
burden by increasing vagal tone.
That same nerve that causes
airway constriction with
heartburn can also be triggered
in sleep apnea.
And then the last issue is the
upper airway. With all this
rhinitis happening, sometimes
the upper airway, it actually it
functions abnormally and can
cause wheezing and shortness of
breath and symptoms that really
aren't asthma. So you have to
make sure that's not going on.
And not to mention, you've ruled
out other diagnoses. So you're
sure that's the diagnosis.
You've really maximized their
treatment. You've addressed
these comorbidities, and yet
these patients are still having
these asthma attacks. So at that
point, I'd start thinking about
a biologic. So you've got all
you've got this patient in front
of you with severe asthma, has
all the characteristics I was
letting you know about, And then
we wanna figure out what kind of
asthma they have because it's
it's not a one size fits all.
It's very heterogeneous, and
there's certain kinds of asthma
that respond well to biologics
and some that don't.
And the five of the six are
really focused on this type two
asthma associated with the
eosinophil. So the eosinophil is
a white cell that you can
measure in the blood. It's in
the lungs. It's in the sinuses
that's associated with sometimes
allergic inflammation, sometimes
non allergic, but it's this type
two inflammation. And with type
two comes these certain proteins
that these cells make.
You might have heard of
interleukin four, interleukin
five, interleukin 13 are sort of
our three favorites. So we look
at the blood eosinophil count
for sure. And if that's elevated
really above about a 50, but
certainly above 300, we really
start taking notice. And then if
possible, try to measure an,
nitric oxide in the exhaled
breath. We call that FeNO.
That's also a measure of
untreated type two inflammation.
So if we see the eosinophils up
and the FeNO up or at least one
of them, we start thinking, k.
This patient has type two
inflammation that's persist
despite maximal therapy. And
then we start thinking that
maybe there are we have
biologics that really target
these type two pathways, which
is really gratifying to be able
to offer that. And then the last
piece I'll say is these are
injectable medications, and
they're very expensive.
So we go through a whole prior
authorization process, which we
can talk some more detail about.
Then it's also really shared
decision making with the patient
because nowadays, they're all
for home use. So patients are
injecting themselves after
teaching. We teach them in the
clinic. Now I have a few
patients that are a little bit
nervous about doing that, so
they actually go to infusion
centers to get their injections
or they come to see us in the
clinic.
I'd say the majority are learn
to inject themselves and feel
comfortable with it. But that's
a very new aspect to asthma
treatment that we really hadn't
really addressed. And I will
say, at least, you know, a lot
of patients embrace it. Some are
a little nervous about it. So
that also goes into the
conversation about whether
they're willing to do this.
And so then we talk about how
long they're gonna be on it,
which is at least four to six
months to make sure that it's
it's working. It really takes
that long to decide if a
biologic is really benefiting a
patient and if they're ready to
take on that challenge. And so
that's where we we sort of we
stop with that. And then, and,
Didi, I'd love to hear your
thoughts from the patient
perspective if I've missed
anything, if there's anything
more you wanna cover.
Speaker 3: Yeah. So just in
regards to shared decision
making, I think that it's
important that patients have a
idea of what that means. Many of
our patients here with the
allergy asthma network, we use
that terminology. They think
they know, but maybe they don't.
And so it gives us an
opportunity to provide maybe a
role modeling or even a video to
talk them through or even a
handout that maybe they can
answer some questions before
they come to meet you.
So then they're prepared for
that, shared decision making
process.
Speaker 1: Mhmm.
Speaker 3: And then they feel
empowered to be a part of the
process to then determine if
biologics are the right answer
for them and their treatment for
their severe abs.
Speaker 2: And I think some of
it, we we had discussed that, it
has to do with, like, how often
you can give the medication,
what also how that works is
conducive to their lifestyle. I
think that's that was one of the
things as well. Right?
Speaker 1: Right. Right. And the
biologics, they're they're
variable in terms of how often
they need to be given depending
on the biologic. There's one
that we give, every two weeks.
There's others that are four,
and some that are and one that's
every eight.
And they're mostly the the sub q
injection. There's one that's in
IV form that we we tend to use
less often. That does require an
infusion center, and it's a
weight based type of dosing. I
have used it, especially for
patients where there's, like,
obesity is a factor and and
wanna make sure and really dose
ideally. I have used it in those
cases, but the vast majority of
the time, we're using the
injectable.
And so that has to be something
very, you know, acceptable to
the patient. Oftentimes, the the
medication gets mailed to their
home once they have a teaching
session and are are interested
in taking it at home, and then
they take it themselves. And
then but the duration or the
frequency is actually really
important because some people
aren't as interested in every
two weeks, but are willing to
maybe try every eight weeks. And
and now I'm happy to say there
was a recent New England Journal
paper suggesting we may have a
inhibitor of interleukin five
coming out that's every six
months. So that's exciting to
think about.
You almost have to put that on
your calendar to remember to
take it.
Speaker 2: That is so exciting.
Oh, go ahead, Didi.
Speaker 3: No. I was just gonna
say that'll be better for
patients who have a little bit
of, needle phobia, if you will,
because, just Right. Again,
we've done a number of focus
groups with patients when it
comes to utilizing biologics.
And so their perception
sometimes are that, you know,
there is a a fear of needle. But
like you said, once we get
through the education, then
patients are willing to accept
that.
You may have mentioned of
timing. And so I can say that
there are some barriers for
timing. We do recognize that
some patients will alter how
long they will go because of the
fact that the cost you may have
mentioned of is, definitely a
barrier for many of our
patients. And so we do we
encourage them to stay with the
with the recommended dosing
schedule, but some patients
actually will let us know. I
actually form make this go a
little bit longer because of the
cost.
Speaker 2: That's interesting.
And and actually, that was we
were we were going to maybe talk
about what are some of the
common challenges or barriers,
to starting biologics. So I
think you've already described
one of them. Doctor Kraft, are
there any other any other
thoughts on the common
challenges you see or barriers
in your patients?
Speaker 1: Absolutely. Well, I
think it's more there's
trepidation about how long do do
like, I get asked a lot, how
long do I have to be on this
medication? The rest of my life?
You know, what does that mean?
So that's number one.
And usually, we go for, like I
said, four to six month trial to
see how well it works. And then
there are patients that have
been on these for years. There's
actually our data now suggesting
you can go a little longer or
there's some that you can
actually taper off, and the
patients do well. About maybe
twenty to thirty percent of
patients who've been very stable
on biologics for a long period
of time can come off and
actually enter a period of what
we might think about as
remission, which is a word that
I never thought I would hear in
the asthma space. Now that
leaves a a pretty large majority
that have to go back, but at
least some seem to have some
some demonstration of remission.
So that's really exciting. So
there's there's that piece.
There's also the whole process
of getting a a biologic
authorized through insurance.
That can take several weeks.
There can be large co pays.
So some of the biologics offer
assistance programs. And what
I've run into recently and I
have to say for a long time,
there really wasn't a lot of
issue around the finances
because, you know, everything
was was covered pretty well in
The US. I've noticed now that
there's a little bit of a chink
in that armor. I'm noticing co
pays a little higher. You know,
insurances wanting me to go with
one biologic versus the other
with no regard to biomarkers,
which is quite upsetting because
I think we practice pretty good
precision medicine and asthma as
best we can.
And to be told from a, carrier
that I have to go with a certain
biologic that I don't think the
patient really would benefit
from is concerning. So that's
another issue. And, also, one
another thing that can happen
that can be a really good thing
is sometimes patients feel good
and they stop their underlying
inhalers because they're feeling
so good. Now that's I call that
a victory. However, when you
when it's time to renew that
biologic, the carriers may not
because they'll notice that the
patient's not taking their
inhaled steroid anymore or
they've drastically reduced the
frequency.
And so while I consider that a
victory from a clinical
perspective, I'll have to ask
the patient to restart their
medicine and stay on it for a
period of time in order to renew
the biologic. And I find that
obviously concerning. So we have
work to do in that arena.
Speaker 3: Mhmm.
Speaker 2: So that's yeah.
Insurance, I guess, is a common
challenge or barrier when it
comes to biologics. And I think
that was, I think the the
thought of transitioning someone
from a on a biologic that maybe
they're well maintained on,
their asthma's well controlled,
and the thought of transitioning
is concerning, I guess. If, we
we were like, we I guess, we
wanted to know what your
thoughts were on transitioning a
patient, I guess, in a perfect
world where maybe you you think
that it's time like, one
biologic might be more
efficacious. Or what are your
thoughts on that?
Speaker 1: You know, actually,
I'm really happy to say there's
been some great data lately on
switching. And so, really, when
we think we do see partial
responses to these biologics. I
I certainly have what I call my
poster children, those patients
who respond beautifully, and
everybody's happy. I wish the
world were like that all the
time. So we have we have, you
know, some who have these
partial responses, so they may
get a little bit better in terms
of reducing their frequency of
exacerbations.
Maybe they have some some small
benefits to lung function, but
overall, not really getting
where they need to be. They're
still requiring prednisone, and
they have a lot of symptoms. The
quality of life isn't quite
where they want it. So at that
point, we might think about
switching. And because these
biologics each target a certain
pathway, and in a perfect world,
I'd love to use combinations to
get more than one.
You know, they're not a steroid,
so that's a really benefit
beneficial aspect. But there
have been data sometimes going
from one to another, changing
the the biologic that targets
one pathway to another can have
benefit. And so that and there
have been a couple of studies
recently suggesting that maybe
the switching doesn't happen as
often. There were, a couple of
very large studies done in, in
Europe where, in fact, only
about ten percent, would were
switched from one, to another.
And so I feel like there like,
there's the the ISAR study I'll
I'll I'll quote, which had about
2,000 patients, and about 200 of
them only switched, two twenty
two to be exact.
And then there was the chronicle
study, which had over 2,000
patients. About, a 62 were the
only ones that switched from one
biologic to another. And so
these were felt to be that was a
registry, the the, International
Severe Aspirin Registry and the
US chronicle study were kind of
real world data. And so I'm
concerned that that isn't
happening as much if patients
really aren't responding.
Because the data suggests that
oftentimes when you do, that
there are some nice results in
terms of reducing exacerbations,
improving symptoms, and
improving lung function.
So I think it's important
whenever patients do start
biologics that they get you
know, monitored. They check-in
with their physician. I I like
to see patients usually about a
month or so after they start
their biologic, and then I may
see them again at four months.
And then if they're doing well,
I may go another three or four
months just to make sure that
first six to seven or eight
months, I I see them quite a bit
to make sure that they're
responding.
Speaker 2: So it sounds like you
you've had you kinda mentioned
that some of the studies maybe
switching isn't something that
they do often, but it sounds
like you've had some positive
clinical scenarios where
switching you've had a benefit
and you might encourage
switching.
Speaker 1: Absolutely. I think
that we do see some partial
responses. Not everyone responds
a %. And so I try to see
patients, you know, usually
within a month of starting a new
biologic and then at least one
or two more times in the first
six to eight months to make sure
they're on track. Because if
they're if they're having
exacerbations on biologics,
usually, I wait till after
they've been on four months.
So anything after four months, I
sort of attribute it to be you
know, to to suggesting that
biologic isn't happening isn't
working as well. And then, so
I'll consider maybe a change. So
I want patients to try them for
at least four months. But
sometimes it'll go a little
longer if it's not really clear
they're having a complete
response. Sometimes I'll go six
to twelve months and then and
then make a decision.
The data out there suggests
that, patients do well when we
change biologics because there
may be more than one well, there
probably is more than one
inflammatory pathway really
raising its head in asthma.
We're only targeting the one
with the biologic. And And I'd
say in a perfect world, I'd love
to use combinations, but, maybe
someday. But for now, I'll have
to switch from one to the other.
And there are nice data
suggesting a reduction in
exacerbations, improvement in
lung function, and I've seen it
in my own practice.
Speaker 2: Yes. That was one of
the questions we wanted to ask
you about the combination, but I
think we we also wanted to know
from the patient perspective.
So, Didi, do you think that
switching biologics, is there
some trepidation there, or what
are your thoughts on that?
Speaker 3: So in regards to
switching, biologics or even
going from one to the other, I
think that patients really if
they understand the reasoning
behind it, then they're they
would be on board. Just kinda
going back to barriers is what,
you know, we've seen is that we
have kind of like five buckets
for the patients. We have a
group of patients who are, have
a great relationship with their
healthcare provider. The staff
works really well with the
patients and make sure that they
get the biologic, that all of
the steps are are very, very
clear as to what they need to
do. We have another group of
patients that maybe they have a
great relationship with their
health care provider, but the
process to get to that biologic
is very muddled.
And so they don't know that this
is coming from a specialty
pharmacy. They don't realize
that there's going to be a phone
call from a biologic
coordinator. They may have been
told that, but because of life
in general, they don't answer
the phone or they're at work.
And so they miss some very
important milestones that then
impact the timing of them
receiving that biologic. And so
then there can be some
frustration that is taking
place.
And so I find that, you know,
again, just that education, we
talked about educating them
about using the biologic, but we
have to also educate our
patients about what the process
is going to look like and why
it's important for them to
follow that process so that when
the time comes for them to
receive that biologic at home,
that they're getting that, you
know, on time and within a
timely manner. But, again,
transitioning biologics,
patients are are they want their
asthma to be better. They have
been living with this for a long
time, and they are very
frustrated when medications are
not working. And so when we get
to that point of using a
biologic or switching from one
to the other, it's magnificent
that they can do that. And then
being able to, again, understand
the process.
And I think doctor Krafft also
talked about cost. So just, you
know, if there is a an
assistance program for patients
is to make sure that they
recognize what that's going to
look like. Because there's a lot
of homework in regards to the
assistance programs too that
many of us may not be aware of.
And so patients need to
recognize that when they are
enrolling in these, that there
there's homework for them to do.
It's not just getting the
assistance of paying for that.
There's more homework for them
to do afterwards.
Speaker 1: Right. That's really
good advice. So today, I had an
interesting I saw a patient who
has very severe asthma, had
stopped smoking, and
unfortunately started up again.
Had been on a biologic, had an
exacerbation. So we with it.
So he but he's been on this
biologic a long time. So is it
time to switch or really focus
on the smoking cessation? And so
we really had a long
conversation about what it would
take to quit smoking, but then
we might consider switching the
biologic after we see the
effects of not smoking because
I'd always had this concern that
this particular biologic is
something that he didn't really
qualify for as well per
biomarkers. He was already on it
when I saw him for the first
time, and I thought another one
might be more appropriate for
him. And so so it's it's an it
was an interesting discussion
that we had.
So we decided that we're gonna
focus. He really wants to quit
smoking, so we're gonna put all
our efforts there. He'll keep up
the other biologic and then come
see me, and then we can decide,
you know, do we need to make
that change? And then we'll go
through the the process to do
that. But explaining that piece
about getting the call from the
coordinator, it's a specialty
pharmacy, I do think that's
really good advice because
there's so many pieces that
happen outside the the office,
you know, for where the visit
was that, can really go well or
not so well.
So, I think you're absolutely
right on that.
Speaker 2: Yeah. I think that
kind of seeing where your
patients are at. Right? So your
patient wants to quit smoking.
That's amazing.
Right? So you really wanna
encourage that and then keep
keep in mind the context of how
you treat them with their
biologics. Mhmm. And then I
think so our our we really
wanted to ask you what your
thoughts were a little bit more
on con combination biologics, if
you ever do it, or have some
strategies.
Speaker 1: I do. You know, as I
mentioned, I I love the concept
of using combinations, and there
actually are ways you can do it.
So if your patient happens to
have atopic dermatitis, there
and severe asthma, there
actually is a a biologic that's
for both. So you might wanna
start that one first. Then, and
then depending on if they
completely respond, say they
don't completely respond, you
have the option of starting
another biologic for the asthma.
So I have done that. The more
common scenario because, you
know, what's interesting is I
don't tend to see as much like
dermatitis with severe asthma.
It's sort of interesting because
I see an adult population, but
chronic rhinosinusitis and nasal
polyps, plenty of that. And so
that tends to really present
itself oftentimes in thirties
and forties. And often in these
days, we have biologics that
target polyps.
And, again, you'll get some
benefit from the asthma. But if
the asthma isn't completely
controlled, then you have the
option of of of thinking of a
second biologic for the asthma.
So I have come up with those
scenarios, and that's the very
legitimate, not trying to, you
know, do anything crazy. And so
it can be a really nice nice way
of using combinations. Didi, I
don't know what you think if
patients have give you any
feedback about that.
Speaker 3: Absolutely. We've had
a number of patients who have
had who have asthma and have
eczema and patients that have
been in studies specifically for
their eczema, who've been placed
on a biologic. And then lo and
behold, they said, oh my gosh,
my asthma is improved. Right.
Well, you get a two for one in
this place.
You do. You do. Helping them
understand that it can be
beneficial for their breathing
as well as for their skin. And
again, I just think that it
really takes a lot of, you know,
education. We haven't really
touched on studies, but we are
we do encourage our patients
that if that could be a health
option or health care option for
them in the event that they
aren't able to afford the co
pays or other arrangements for
paying for their medication is
that they could have an
opportunity to participate in a
study that may benefit them to
receive those biologics
Speaker 1: too. Absolutely. And
I'm glad you brought that up
because, we do trials, and we I
have a usually, I have a
research coordinator with me in
clinic thinking about those
patients who may wanna do these
trials. Sometimes they're
biologic focused, sometimes
they're not. I think my patients
are pretty used to it now.
They're used to being offered
studies. And, you know, usually,
they're they're quite willing
depending on the trial and where
they are with their asthma and
if they feel like they wanna try
something. And I really
appreciate that because how are
we going to learn, you know,
about new approaches, you know,
new new, interventions if we if
we don't have those willing
participants. So I'm really
grateful for that.
Speaker 2: It sounds like such a
wonderful clinic that you have.
And so we're so happy that
you're able to give us your
expertise today and how maybe we
can treat our patients better
and learning from you today. So
we were wondering if you think,
any thoughts on future, things
in the pipeline. I know you
already mentioned the six month
biologics, so that's exciting.
Any other thoughts on where
we're headed into the future?
Yeah.
Speaker 1: You know, there are
some really interesting things
happening down the road. We
have, in addition to this long
acting IL five inhibitor,
dapimocumab, that's also, that
so that's that was just
published as a phase three. So
that's moving along. There's an
interesting, phase three study
going on where looking at a a
TSLP inhibitor and an IL
thirteen inhibitor called
lunececumig. And, it's actually
phase two, I should say.
And what that is is it's a
interesting nanobody backbone.
This is an injectable medicine
where you can put different
inhibitors onto the same medic
onto the same drug, if you will.
So this one has two biologics on
it. So TSLP is a mediator
produced by those epithelial
cells that line the the lung,
and they're sort of the first
item defense, if you will. And
so it's it's suppressing TSLP,
which can create a lot of this
type two inflammation and also
non type two for that matter.
And then it also inhibits IL 13,
which is a type two cytokine, so
you get two for one in that one.
There's also speaking of TSLP,
there's an inhaled TSLP
inhibitor that's now in in in
studies as well. So that's
looking very, interesting. And
so we'll see where that takes
us. There's also, emacitinib,
which is an tyrosine kinase
inhibitor affecting some of the
mast cell functions.
A mast cell is one of these
inflammatory cells in the lung
and the sinuses that can release
a lot of mediators, especially
like leukotrienes and other
preformed cytokines that can
cause this airway inflammation
that we that, you know, results
in shortness of breath, wheeze,
and cough. And, and then IL
interleukin 33, which is a
cytokine that's also produced by
that airway epithelium, that's
been it was looked at asthma for
a while, and then it moved to
COPD. So there's some
interesting trials in the phase
three space looking at IL 33. It
looks like it's coming back to
asthma. So we'll see what what
that does.
So I think I I could go on and
on. The the pipeline is quite
rich, and so I'm I'm excited
about the future for sure.
Speaker 2: Yeah. I'm really
excited about the all the the
asthma treatments, but then also
the COPD. So I see a lot of
patients with COPD, so I'm I'm
super excited.
Speaker 1: Oh, definitely. It's
nice to have options for COPD
because that's really a big
unmet need as well. You bet.
Speaker 2: Yes. There was a
while where it just felt like
there wasn't a lot coming down
the pipeline, so we're so
excited too. It sounds like,
Didi, so patients are pretty
pretty excited about the future
of asthma. Is that what are your
thoughts when they kind of
thinking about the future of
biologics?
Speaker 3: So I think patients
are excited about the future,
but we have to remember, you
know, social determinants of
health do impact the access to
these medications. And then
we've talked a little bit about
research. So again, patients
know what they are provided or
if they go and do a doctor
Google research, And Doctor.
Google is not the answer. So we
want to be the AAN wants to be
the resource of all so that
patients, when they're looking
for information and many of our
patients are going out on
TikTok, right, where they're
going out on other types of
social media to find information
about the future of asthma.
So allergy asthma networks
actually created a TikTok
channel to be able to be a well
known resource that is credible
and having credible influencers
like Doctor. Kraft or some
others physicians and even
patients who are using the
science to share their
information. We've also utilized
podcasts to get information out
about studies and about the
future of asthma, severe asthma
specifically. And even, just
recently, we had a biologic
podcast specific for patients.
So we had a patient being
interviewed with a health care
provider.
So I think patients are very
excited, but just also just
remembering that, you know, when
we're thinking about where
medications are going is making
sure that we have access to all
so that those social
determinants of health actually
don't impact who gets and who
doesn't receive that medication.
Speaker 2: Yeah. That's a great
point. I mean, we you know,
there's all this exciting
medications out there, but if we
can't get them to our patients,
or they're not able you know,
we're we talked a lot a lot
about barriers, insurance, all
these issues. So that is the
real world, unfortunately, that
we live in. So, well, that was
such an amazing talk, and we
just wanna thank doctor Kraft
and Didi again for this really
this, learning so much about
biologics today on the ATS
Breathe Easy podcast.
So we just wanna thank them
again.
Speaker 1: Thank you. Thank you
for having us. It's great to be
here. We appreciate it.
Speaker 2: Thank you for joining
us for today's ATS Breathe Easy
episode. Please subscribe and
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