Vamsipedia · Clinical AI

Biologic Select

Severe asthma and type 2 disease

Rank the agent from the endotype — then follow response, remission and relapse. A Vamsipedia laboratory tool.

IgEIL-4
IL-5eosinophils
IL-4/13FeNO
TSLPalarmin

Selector

Choose the biologic from the endotype

Patient entry

ReadyAll five prerequisites confirmed.

Prerequisites5/5

Diagnosis secure — asthma mimics excludedAdherence verified (canister check / caregiver report)Inhaler technique checked and re-reinforcedComorbidities addressed (rhinosinusitis, GERD, VCD, obesity, thyroid)On adequate therapy — high-dose ICS-LABA ± LAMA / LTRA

Patient

AgeyearsWeightkgHeightcmBMI

23.9

Primary indicationAge at onsetSmokingBackground therapy

Biomarkers

Each number is a cytokine reporter: eosinophils → IL-5, FeNO → IL-13, IgE → IL-4. GINA uses the highest blood eosinophil count in the last 12 months.

Blood eosinophilscells/µL12-month peak eoscells/µLTotal IgEIU/mLFeNOppbSputum eos% (optional)Periostinng/mL (opt.)Aeroallergen sensitisationSPT / specific IgE

Clear allergen-driven symptom pattern

Disease burden

Exacerbationslast 12 moACT5–25ACQ-5optionalPost-BD FEV₁% predSystemic steroid use

Hospitalisation or ED attendance in last year

Comorbidities0

Prior biologic

Agent already trialled

Practical constraints

Needs the least frequent dosing possible (travel / distance)Wants home self-administrationCost is the dominant constraintRestrict to agents marketable in IndiaEndemic helminth exposure / untreated strongyloidiasis riskTB-endemic setting — screen before immunosuppressionPregnant or planning pregnancy

Inferred endotype

Overlapping allergic and eosinophilic

AllergicEosinophilic3 exacerbations/year

IgE300 IU/mL · perennial sensitisation

IL-4-driven allergic pathway engaged

IL-4 → class switch → IgE

IL-5520 cells/µL (12-mo peak)

Strongly eosinophilic — IL-5 dominant

IL-5 → eosinophilopoiesis

IL-4/1335 ppb

Raised IL-13 tone

IL-13 → epithelial iNOS → FeNO

TSLPUpstream of all T2 signalling

Broad mechanism, no biomarker gate

TSLP → ILC2 / Th2 priming

Blood eosinophils 520 cells/µL report IL-5-driven eosinophil survival (current 450, 12-month peak 520 — GINA uses the peak).
FeNO 35 ppb reports IL-13-induced epithelial iNOS — not IL-5. Raised, so the IL-4/13 axis is in play alongside whatever the eosinophils say.
Total IgE 300 IU/mL with perennial sensitisation reports IL-4 class-switch and is the dosing input for omalizumab.

Open the cytokine–biomarker map

Ranked options— filtered to agents marketable in India

Not eligible: Depemokimab — not approved in India — excluded by your availability filter · Reslizumab — not marketed in India — excluded by your availability filter · Tezepelumab — not approved in India — excluded by your availability filter

Benralizumab

Anti-IL-5RαMarketed in India

Regimen for this patient

30 mg every 4 weeks for three doses, then 30 mg every 8 weeks

Six injections in the first year after the loading phase, then six a year — the lowest attendance burden of the domestically marketed agents.

Verify before prescribing

Doses shown are computed from the entered values and the published regimens. Confirm every one against the current product labelling.

Why this agent ranked here

Factor	Weight
Eosinophils ≥500 — strongest IL-5 response predictor	+34
≥3 exacerbations — strong predictor	+26
Adult-onset asthma — predicts IL-5 response	+14
Near-complete eosinophil depletion via IL-5Rα	+8