Which class of biologic agent do you use first in a patient with asthma who may qualify for multiple drugs?

This is a situation where shared decision making with the family is best. It would be helpful to discuss what the patient's and families' goals or priorities are. For instance, if the patient is on chronic steroids or receives multiple courses, studies have shown that mepolizumab, benralizumab, and dupilumab are good options. Omalizumab, mepolizumab, benralizumab, dupilumab, and tezepelumab have been shown to decrease exacerbation rates. Additionally, if the patient has other comorbidities such as eczema or eosinophilic esophagitis, dupilumab may be a good option. If the patient has comorbid nasal polyps, they could try dupilmab, mepolizumab or omalizumab. Omalizumab is also FDA approved for chronic spontaneous urticaria. The frequency of ...