Asthma and respiratory care, including biologics
Asthma is inflammation and narrowing of the airways, and controlling it well means measuring it rather than estimating it. At Allergenix that means spirometry and FeNO testing performed in the clinic, a written plan built around reducing how often you need a rescue inhaler, and — for asthma that has not responded to standard treatment — initiating a powerful biologic therapy.
Asthma that is genuinely controlled looks different from asthma that is merely survived. Measuring it is the first step.
- 45–60 min
- first appointment
- Same day
- spirometry and FeNO results
- Complimentary
- for both, when indicated — billed separately elsewhere
Does any of this sound like your asthma?
- You reach for a rescue inhaler more often than you would like
- Your breathing is worse at particular times of year, or at night
- You have been on the same plan for years without it being remeasured
- Exercise, cold air or a cold sets you back further than it should
- You can't exercise or be active like you used to
- You have a chronic cough
- Your child coughs all the time or wakes up at night
What an asthma evaluation can involve
Spirometry
Lung function measured in the clinic, so a plan is built on a verified and accurate measurement rather than on how a given week felt.
FeNO testing
A breath measure of airway inflammation, used alongside spirometry to see what is actually driving symptoms.
Biologic therapy
For asthma that has not responded to standard treatment, Allergenix applies cutting edge biologics to improve symptoms dramatically.
Control plans
Built around reducing how often you need a rescue inhaler, and remeasured rather than assumed.
Biologic therapy, administered here
For moderate-to-severe asthma that hasn't responded to standard treatment, biologics target the immune pathways driving it rather than managing symptoms downstream. They are prescribed and monitored by the same physician who read your testing, and most are self-administered at home.
Which biologic is appropriate depends on your testing.
- Xolair®
- Dupixent®
- Nucala®
- Fasenra®
- Tezspire®
- Exdensur®
Spirometry and FeNO, and what each one measures
These two tests answer different questions, and running both is what separates a measured asthma plan from an estimated one.
Spirometry
- Measures how much air you can move, and how fast
- You breathe out as hard and as long as you can into a mouthpiece, several times
- Shows whether your airways are obstructed, and by how much
- Often repeated after a bronchodilator — reversible obstruction is one of the defining features of asthma
FeNO
- Measures nitric oxide in your breath, which rises when a specific type of airway inflammation is present
- Tells you whether inflammation is currently active
- And whether it is the type that responds well to inhaled steroids
A high FeNO in someone whose symptoms are poorly controlled often means the treatment is right but is not being taken consistently, or that the dose is too low.
Both are separately billable tests at an insurance-based practice, charged on top of the visit. Here they are part of it, when clinically indicated.
- Same day
- both performed in the clinic and read with you
- $0
- for both, when clinically indicated
Biologic therapy for severe asthma
Biologics are for asthma that remains poorly controlled despite correct use of inhaled therapy. They are injected antibodies that block a specific step in the inflammatory process, and which one is appropriate depends on what your testing shows is driving your asthma — allergic sensitization, eosinophilic inflammation, or a broader upstream pathway.
- Xolair (omalizumab)
- targets IgE and is used for allergic asthma. It is also approved for chronic hives.
- Nucala (mepolizumab) and Fasenra (benralizumab)
- target the interleukin-5 pathway and are used for eosinophilic asthma, identified by a blood eosinophil count.
- Dupixent (dupilumab)
- targets the interleukin-4 and interleukin-13 pathways. It is used for asthma and also for eczema and chronic sinus disease with nasal polyps, which makes it useful for patients who have more than one of those at once.
- Tezspire (tezepelumab)
- acts further upstream and is not restricted to a particular inflammatory phenotype, which makes it an option where the others are not a good fit.
- Exdensur (depemokimab)
- also targets interleukin-5, and is given once every six months rather than every few weeks — the longest-acting of these.
Deciding among them requires bloodwork, lung function testing and a review of your history. That evaluation is done here rather than referred out, and most of these are then self-administered at home. Biologics carry their own risks and monitoring requirements, which are discussed in full before starting.
Every fee is published before you book — what testing costs sets out the figures for this. When the answer turns out to be a program rather than a prescription, four different immunotherapy treatments become options to assist your symptoms. What a first visit involves walks through the visit itself, and Dr. Stanga runs all of it — the evaluation, the testing and the plan.
WHAT YOU LEAVE WITH
A measured picture of your lung function and airway inflammation, and a plan aimed at fewer rescue inhalers rather than more prescriptions.
Questions about asthma
Do I pay you for biologics?
Not for the drug. Biologics are dispensed on your prescription benefit through a specialty pharmacy, which bills for the medication itself. What Allergenix charges is $800 per year, flat for biologic therapy coordination: the clinical management and the extensive prior authorization work required to get one approved and keep it approved. One figure, loaded once, with no step increases.
How do I know if my asthma is actually well controlled?
The usual markers are needing a rescue inhaler more than twice a week, waking at night because of symptoms, or having had a course of oral steroids in the past year. Any of those means control is not where it should be, even if it feels normal because it has been that way a long time.
Can adults develop asthma?
Yes. Adult-onset asthma is common and behaves somewhat differently from childhood asthma — it is less often allergic and more often associated with eosinophilic inflammation, which affects which treatments work best. It is also more likely to be misattributed to being out of shape or getting older.
Is asthma related to allergies?
Frequently. Allergic asthma is the most common form, and identifying what you react to often explains the pattern of your symptoms. Treating the underlying allergy — including with immunotherapy — can improve asthma control alongside inhaled treatment.
What is FeNO testing?
A breath test measuring nitric oxide, which rises when a particular type of airway inflammation is present. It shows whether inflammation is active right now, which spirometry cannot. It takes under a minute and is complimentary when clinically indicated.
Do you prescribe biologics, or refer out for them?
The evaluation is done here rather than referred out, and it requires bloodwork and lung function testing to establish which pathway is driving your asthma, since the biologics are not interchangeable. Most are then self-administered at home.
Do I need a referral?
No. Allergenix does not require a referral from anyone, and does not bill insurance, so there is no prior authorization to obtain.
A different approach to allergy treatment starts here
Enrollment takes about two minutes. We'll confirm your visit within one business day and send everything you need beforehand.
