Guidance for Administering Biologics for Severe Asthma and Allergic Conditions

Table 1

When can biologic treatment be administered?.

	Biologic
	Xolair (omalizumab)	Fasenra (benralizumab)	Nucala (mepolizumab)	Dupixent (dupilumab)	Cinqair (reslizumab)
Patient’s condition, treatment/vaccine, or timing
Hypertension	✔	✔	✔	✔	✔
Fever	✔	✔	✔	✔	✔
Chronic chest pain	✔	✔	✔	✔	✔
Pneumonia or other respiratory illness	✔	✔	✔	✔	✔
Antibiotics	✔	✔	✔	✔	✔
Active parasitic (helminth) infection	Hold until treatment is completed	Do not give	Do not give	Do not give	Do not give
Before or after surgery	✔	✔	✔	✔	✔
Headache	✔	✔	✔	✔	✔
Pregnancy^a and breastfeeding	✔	✔	✔	✔	✔
Inactivated vaccine	✔	✔	✔	✔^b	✔
Live-attenuated vaccines	✔	✔	✔	Do not give	Do not give

^aBiologics should not be initiated during pregnancy, but current treatment should be continued. ^bSome physicians may consider holding treatment based on a risk/benefit discussion of optimal immunity.