If you or someone you love has severe, hard-to-control asthma — frequent attacks, repeated hospital visits, daily oral steroids, and a life lived in fear of the next exacerbation — this guide is written specifically for you. Severe asthma is not a life sentence. In 2026, biologic therapies have transformed outcomes for patients who were previously considered untreatable, and Pulmovista Clinics, under the expert care of Dr. Dixit Kumar Thakur, is one of Delhi’s leading centres for delivering this transformative treatment.
In this comprehensive guide, Dr. Dixit Kumar Thakur explains what severe asthma truly is, why so many patients in Delhi remain undiagnosed and undertreated, how biologic therapies work and which one may be right for you, and why Pulmovista Clinics offers the best asthma treatment in Delhi for hard-to-control cases — the second time this distinction matters, because for severe asthma patients, getting to the right specialist is not just about comfort. It can be life-saving.
1. What Is Severe Asthma? Understanding the Diagnosis
The term ‘severe asthma’ is often used loosely by patients and even some clinicians to mean ‘bad asthma.’ But in medical terms, severe asthma has a precise definition that determines eligibility for advanced treatments including biologic therapy.
According to GINA 2026, severe asthma is defined as asthma that requires high-dose ICS-LABA therapy to maintain control — or asthma that remains uncontrolled despite this level of treatment. Crucially, the definition requires that other diagnoses have been excluded and that contributing factors (poor adherence, incorrect inhaler technique, comorbidities, triggers) have been identified and addressed.
The Three Categories of Difficult-to-Treat Asthma
| Category | Definition | What It Means for You |
| Difficult-to-treat asthma | Asthma uncontrolled despite Step 3–4 therapy, but due to modifiable factors | Usually fixable — inhaler technique, adherence, comorbidities, triggers |
| Severe asthma | Asthma requiring Step 5 therapy (high-dose ICS-LABA ± add-ons) to stay controlled | Specialist care essential — biologic therapy assessment needed |
| Refractory severe asthma | Asthma that remains uncontrolled even at Step 5 with optimal therapy | Biologic therapy is the primary treatment solution — Pulmovista Clinics specialises in this group |
| ⚠ Are You Being Misclassified as ‘Severe’? At Pulmovista Clinics, Dr. Dixit Kumar Thakur finds that a significant proportion of patients referred as ‘severe asthma’ actually have difficult-to-treat asthma with correctable factors — most commonly incorrect inhaler technique, poor adherence to controller medication, and untreated comorbidities like allergic rhinitis or GERD. This is critically important: patients labelled severe who are not truly severe may be missing simple fixes that could transform their control. Equally, patients who ARE truly severe are frequently under-diagnosed and denied access to biologic therapies that could change their lives. The only way to know which category you are in is a thorough specialist assessment at a centre like Pulmovista Clinics. |
How Common Is Severe Asthma in Delhi?
Severe asthma affects approximately 5–10% of all asthma patients worldwide. In Delhi, this proportion may be higher due to the compounding effect of chronic PM2.5 exposure, which drives airway remodelling and steroid-resistant inflammation over time. With an estimated 3–4 million asthma patients in Delhi NCR, this translates to 150,000–400,000 individuals with severe asthma — the majority of whom have never been formally assessed for biologic therapy.
2. Why Hard-to-Control Asthma Is Especially Common in Delhi
Delhi creates a uniquely hostile environment for asthma patients. The combination of pollution, allergens, and weather extremes that characterises life in this city directly contributes to the development and persistence of severe, hard-to-control asthma through several well-documented biological mechanisms.
PM2.5: The Engine of Severe Airway Disease
Fine particulate matter (PM2.5) at Delhi’s chronically elevated levels — frequently 5–7 times the WHO annual guideline — causes progressive and cumulative damage to the airways over years of exposure:
• Airway remodelling: Long-term PM2.5 exposure causes structural changes to the bronchial walls — thickening of the smooth muscle layer, increased mucus gland size, and subepithelial fibrosis. These structural changes are largely irreversible and explain why many long-term Delhi residents develop increasingly severe asthma over time.
• Steroid-resistant inflammation: PM2.5 drives neutrophilic airway inflammation — a type that responds poorly to inhaled corticosteroids. This is why many Delhi patients find that even high-dose ICS therapy provides incomplete control.
• Oxidative stress: Particulate matter generates reactive oxygen species that overwhelm the lung’s antioxidant defences, amplifying inflammatory responses and making the airways hyper-reactive to even minor additional triggers.
• Impaired mucociliary clearance: PM2.5 damages the cilia lining the airways — the microscopic hair-like structures responsible for clearing mucus and particles. This leads to mucus plugging, recurrent respiratory infections, and worsening airflow obstruction.
Delhi’s Allergen Landscape: A Year-Round Severe Asthma Driver
Unlike many cities where allergen exposure is seasonal, Delhi residents face a virtually year-round high allergen burden:
• House dust mites: Delhi’s monsoon humidity creates ideal conditions for year-round high dust mite populations — the single most common sensitiser in allergic severe asthma.
• Cockroach allergens: Cockroach droppings are a major year-round allergen in Delhi homes, particularly in older or less well-maintained buildings.
• Aspergillus and mould spores: Monsoon humidity drives explosive mould growth — Aspergillus sensitisation can cause ABPA (Allergic Bronchopulmonary Aspergillosis), a complication of severe asthma requiring specialist management.
• Tree and grass pollens: Mulberry, Prosopis, and grass pollens create seasonal peaks that can destabilise even well-managed severe asthma.
3. Signs That Your Asthma May Be Severe: Dr. Dixit Kumar Thakur’s Checklist
Many patients with severe asthma in Delhi have been living with inadequate control for years — normalising symptoms that are, in fact, markers of serious disease. Dr. Dixit Kumar Thakur at Pulmovista Clinics urges any patient experiencing the following to seek urgent specialist review:
| ✔ Pulmovista Clinics: Severe Asthma Red Flags — Seek Specialist Review If You Have: ✔ 2 or more severe asthma attacks in the past 12 months requiring oral steroids, ER visits, or hospitalisation ✔ Daily symptoms despite using a high-dose ICS-LABA combination inhaler regularly and correctly ✔ Waking at night with asthma symptoms 3 or more times per week ✔ Oral corticosteroid (OCS) dependence — needing oral prednisolone for weeks or months at a time ✔ FEV₁ (lung function) persistently below 80% of predicted despite maximum inhaler therapy ✔ Significant limitation of daily activities, work, exercise, or social life due to asthma ✔ Asthma that has required ICU admission or mechanical ventilation at any point ✔ Rapidly worsening asthma despite previously good control — especially in autumn/winter in Delhi |
| “The patients I worry most about at Pulmovista are not the ones who come to see me in crisis — it is the ones who have quietly accepted a life of severe, uncontrolled asthma as their normal. By the time some of these patients arrive, they have been on oral steroids for years, with significant steroid-related complications, when biologic therapy could have spared them all of that. Please do not wait.” — Dr. Dixit Kumar Thakur, Pulmovista Clinics, Delhi |
4. Biologic Therapy for Severe Asthma: The Complete 2026 Guide
Biologic therapies represent the most significant breakthrough in asthma treatment in a generation. These are precision-medicine injectable treatments that target specific molecular pathways driving severe airway inflammation — pathways that inhaled corticosteroids and bronchodilators simply cannot reach. For eligible patients, the results can be genuinely life-changing.
At Pulmovista Clinics, Dr. Dixit Kumar Thakur is one of Delhi’s most experienced specialists in the assessment, prescription, and long-term management of biologic therapies for severe asthma. Below is a complete guide to every approved biologic currently available.
How Do Biologic Therapies Work?
Unlike conventional asthma medications that provide broad anti-inflammatory or bronchodilatory effects, biologics are monoclonal antibodies — highly specific proteins that bind to and neutralise a single target molecule in the inflammatory cascade driving severe asthma. The result is a precise, targeted interruption of the disease process at its molecular root.
The key to biologic therapy success is matching the right biologic to the right patient based on their specific inflammatory phenotype — identified through biomarker testing. This is where specialist expertise at a centre like Pulmovista Clinics is essential.
Biologic 1: Omalizumab (Xolair) — Anti-IgE Therapy
| Omalizumab (Xolair) | Key Details |
| Target | IgE (Immunoglobulin E) — the master antibody of allergic disease |
| Mechanism | Binds free IgE in the blood, preventing it from triggering mast cell degranulation and the allergic inflammatory cascade |
| Best for | Moderate-to-severe allergic asthma with elevated total IgE and proven allergen sensitisation |
| Biomarker required | Total serum IgE ≥30–1500 IU/mL + positive allergen sensitisation (skin prick or specific IgE) |
| Dosing | Subcutaneous injection every 2–4 weeks (dose based on weight and IgE level) |
| Clinical results | ~50% reduction in exacerbations; significant reduction in rescue inhaler use and oral steroid need |
| Available at Pulmovista | Yes — full eligibility assessment and ongoing monitoring by Dr. Dixit Kumar Thakur |
Omalizumab is particularly relevant for Delhi patients because allergic asthma — driven by dust mites, cockroach, moulds, and pollens — is the most prevalent severe asthma phenotype in this city. If you have documented allergic sensitisation and poorly controlled asthma despite high-dose ICS-LABA, Omalizumab assessment at Pulmovista Clinics should be your next step.
Biologic 2: Mepolizumab (Nucala) — Anti-IL-5 Therapy
| Mepolizumab (Nucala) | Key Details |
| Target | IL-5 (Interleukin-5) — the primary cytokine driving eosinophil production and survival |
| Mechanism | Blocks IL-5 signalling, dramatically reducing blood and airway eosinophil counts |
| Best for | Severe eosinophilic asthma with elevated blood eosinophils (≥300 cells/µL at assessment, or ≥150 on OCS) |
| Biomarker required | Blood eosinophil count — simple blood test available at Pulmovista Clinics |
| Dosing | 100mg subcutaneous injection every 4 weeks |
| Clinical results | ~50% reduction in exacerbations; significant oral corticosteroid-sparing effect |
| Available at Pulmovista | Yes — Dr. Dixit Kumar Thakur has extensive experience with Mepolizumab in Delhi patients |
Biologic 3: Benralizumab (Fasenra) — Anti-IL-5Rα Therapy
| Benralizumab (Fasenra) | Key Details |
| Target | IL-5 receptor alpha (IL-5Rα) — the receptor on eosinophils and basophils |
| Mechanism | Directly depletes eosinophils and basophils via antibody-dependent cellular cytotoxicity — faster and more complete than Mepolizumab |
| Best for | Severe eosinophilic asthma — particularly patients who need rapid eosinophil depletion |
| Biomarker required | Blood eosinophils ≥300 cells/µL (or ≥150 on OCS) |
| Dosing | 30mg SC injection every 4 weeks for 3 doses, then every 8 weeks — convenient maintenance schedule |
| Clinical results | ~50% exacerbation reduction; up to 75% OCS dose reduction in OCS-dependent patients |
| Available at Pulmovista | Yes — 8-weekly maintenance makes this highly convenient for Delhi patients |
Biologic 4: Dupilumab (Dupixent) — Anti-IL-4/IL-13 Dual Pathway Therapy
| Dupilumab (Dupixent) | Key Details |
| Target | IL-4Rα — blocks signalling of both IL-4 and IL-13 simultaneously (dual pathway blockade) |
| Mechanism | Interrupts two key Type 2 inflammatory cytokines, providing broader anti-inflammatory coverage than IL-5 targeting alone |
| Best for | Moderate-to-severe Type 2 asthma; especially valuable for patients with comorbid atopic dermatitis or chronic rhinosinusitis with nasal polyps (CRSwNP) |
| Biomarker required | Blood eosinophils ≥150 cells/µL OR FeNO ≥25 ppb |
| Dosing | 200mg or 300mg SC injection every 2 weeks (self-injectable at home after training) |
| Clinical results | ~46% exacerbation reduction; significant lung function improvement (FEV₁ +0.14–0.18L); OCS-sparing |
| Available at Pulmovista | Yes — particularly recommended for patients with overlapping atopic conditions — common in Delhi |
Biologic 5: Tezepelumab (Tezspire) — Anti-TSLP Upstream Therapy
| Tezepelumab (Tezspire) | Key Details |
| Target | TSLP (Thymic Stromal Lymphopoietin) — an upstream ‘alarm cytokine’ released by airway epithelium in response to triggers |
| Mechanism | Blocks TSLP before the entire inflammatory cascade begins — the most upstream biologic currently available, covering both Type 2 and non-Type 2 inflammation |
| Best for | Severe asthma across ALL phenotypes — including patients with low eosinophils who do not qualify for IL-5 biologics |
| Biomarker required | No specific biomarker threshold required — broadest eligibility of all approved biologics |
| Dosing | 210mg SC injection every 4 weeks |
| Clinical results | ~70% exacerbation reduction in high eosinophil patients; ~40% in low eosinophil patients — significant across all groups |
| Available at Pulmovista | Yes — Dr. Dixit Kumar Thakur recommends Tezepelumab for severe asthma patients who do not fit other biologic profiles |
5. How Dr. Dixit Kumar Thakur Selects the Right Biologic at Pulmovista Clinics
Biologic selection is not guesswork. At Pulmovista Clinics, Dr. Dixit Kumar Thakur follows a structured, evidence-based biomarker assessment protocol before recommending any biologic therapy. The wrong biologic — or a biologic prescribed without proper phenotyping — will deliver poor results and unnecessary expense.
| 🩺 Pulmovista Clinics: Dr. Dixit Kumar Thakur’s Biologic Selection Protocol Step 1 — Confirm severe asthma diagnosis and rule out modifiable factors (adherence, inhaler technique, comorbidities) Step 2 — Spirometry: measure FEV₁, FVC, and bronchodilator reversibility to confirm and grade obstruction Step 3 — FeNO testing: quantify eosinophilic airway inflammation (normal <25 ppb; elevated ≥25 ppb guides ICS and biologic decisions) Step 4 — Blood eosinophil count: key biomarker for IL-5 pathway eligibility (Mepolizumab, Benralizumab) and Dupilumab Step 5 — Total serum IgE + allergen sensitisation panel: determines Omalizumab eligibility Step 6 — Comorbidity assessment: CRSwNP, atopic dermatitis, GERD, OSA — guides preference for Dupilumab in overlapping conditions Step 7 — Exacerbation history review: frequency, severity, OCS courses, hospitalisations in past 12 months Step 8 — Biologic selection discussion: Dr. Thakur presents options, explains evidence, and makes a shared decision with the patient Step 9 — First administration at Pulmovista Clinics with 30-minute observation period Step 10 — Structured monitoring: response assessed at 4 months; continued if clinically significant benefit demonstrated |
Quick Reference: Which Biologic for Which Patient?
| Biologic | Primary Biomarker | Best Patient Profile in Delhi |
| Omalizumab | Total IgE ≥30 IU/mL + allergen sensitisation | Allergic asthma — dust mite, cockroach, mould, pollen sensitised patients |
| Mepolizumab | Eosinophils ≥300 cells/µL | Severe eosinophilic asthma; frequent OCS courses; nasal polyps |
| Benralizumab | Eosinophils ≥300 cells/µL | Severe eosinophilic asthma needing rapid depletion; convenient 8-weekly dosing |
| Dupilumab | Eosinophils ≥150 OR FeNO ≥25 | Type 2 asthma + atopic dermatitis / CRSwNP — Delhi’s atopic patients |
| Tezepelumab | No threshold — broad eligibility | Severe asthma any phenotype; low eosinophil patients; non-Type 2 asthma |
6. What Results Can You Expect from Biologic Therapy?
The clinical trial data supporting biologic therapies for severe asthma is among the most compelling in modern respiratory medicine. For patients who have suffered for years with uncontrolled severe asthma, the results achieved in practice at Pulmovista Clinics mirror what the trials demonstrate:
| ✅ Typical Outcomes of Biologic Therapy at Pulmovista Clinics for Severe Asthma in Delhi ✅ 50–70% reduction in severe asthma exacerbations per year ✅ Significant reduction or complete elimination of oral corticosteroid (OCS) dependence ✅ Measurable improvement in FEV₁ (lung function) — typically +100–200mL at 4–6 months ✅ Dramatic improvement in quality of life, sleep quality, and exercise tolerance ✅ Reduction in emergency department visits and hospitalisations ✅ Freedom from the long-term side effects of chronic oral steroid use — including osteoporosis, diabetes, weight gain, and cataracts ✅ Most patients notice meaningful improvement within 4–8 weeks of the first injection |
| “I had a patient at Pulmovista — a 42-year-old schoolteacher from South Delhi — who had been on daily oral prednisolone for three years for severe eosinophilic asthma. She had developed steroid-induced diabetes and osteopenia. Six months after starting Benralizumab, she was completely off oral steroids, her FEV₁ had improved by 22%, and she told me she had forgotten what it felt like to breathe normally. That is what biologic therapy can do.” — Dr. Dixit Kumar Thakur, Pulmovista Clinics, Delhi |
How Long Does Biologic Therapy Take to Show Results?
| Timeframe | Expected Milestones |
| 4–8 weeks | Reduction in rescue inhaler use; improved sleep; early symptom improvement |
| 3–4 months | Measurable reduction in exacerbation frequency; beginning of OCS taper (where applicable) |
| 6 months | Formal response assessment at Pulmovista Clinics — spirometry + FeNO + quality-of-life scoring |
| 12 months | Full exacerbation-reduction benefit established; OCS-free or OCS-minimised in most responders |
| Long-term | Ongoing therapy with regular review — most patients continue biologic indefinitely given sustained benefit |
7. The Cost of Biologic Therapy in India: What Delhi Patients Need to Know
One of the most common questions Dr. Dixit Kumar Thakur receives at Pulmovista Clinics is about the cost of biologic therapy. It is a fair and important question — biologic injections are significantly more expensive than standard asthma inhalers, and this is a barrier for many patients.
However, there are several important considerations that Dr. Dixit Kumar Thakur discusses with all Pulmovista patients during the biologic therapy consultation:
• Patient assistance programmes: All major biologic manufacturers — AstraZeneca (Benralizumab), GSK (Mepolizumab), Novartis (Omalizumab), Sanofi/Regeneron (Dupilumab), and AstraZeneca (Tezepelumab) — offer patient support programmes in India that can substantially reduce out-of-pocket cost for eligible patients. Dr. Thakur helps Pulmovista patients access these programmes.
• Cost of uncontrolled severe asthma: The true cost of severe, uncontrolled asthma is frequently underestimated. Repeated emergency department visits, hospitalisations, ICU admissions, and the long-term health costs of chronic oral steroid use (diabetes management, osteoporosis treatment, cataract surgery) can far exceed the cost of biologic therapy over time.
• Productivity and quality of life: Severe asthma significantly impairs work productivity, career progression, and educational attainment. For working adults in Delhi, the economic cost of poorly controlled severe asthma extends well beyond direct medical expenses.
• Insurance coverage: An increasing number of Indian health insurance policies now cover biologic therapies for severe asthma. Dr. Dixit Kumar Thakur and the Pulmovista Clinics team provide all necessary documentation to support insurance claims.
| 💡 Pulmovista Clinics Financial Support for Biologic Therapy At Pulmovista Clinics, Dr. Dixit Kumar Thakur and the clinical team are committed to making biologic therapy accessible to eligible patients regardless of financial constraints. We assist with: • Patient assistance programme applications for all approved biologics • Insurance pre-authorisation documentation • Phased treatment planning where needed • Regular cost-benefit review at each follow-up appointment Contact Pulmovista Clinics at www.pulmovista.com to discuss your specific situation. |
8. Beyond Biologics: The Complete Pulmovista Clinics Approach to Severe Asthma
At Pulmovista Clinics, Dr. Dixit Kumar Thakur takes a holistic, multi-dimensional approach to severe asthma management. Biologic therapy is a powerful tool — but it works best when integrated into a comprehensive treatment plan that addresses every factor contributing to poor asthma control.
Comorbidity Management: The Hidden Driver of Severe Asthma
Studies consistently show that treating asthma comorbidities can dramatically improve overall asthma control — sometimes as effectively as stepping up asthma-specific therapy. At Pulmovista Clinics, every severe asthma patient is screened and treated for:
• Allergic rhinitis and chronic rhinosinusitis: Untreated upper airway disease directly worsens lower airway asthma through the ‘unified airway’ mechanism — nasal inflammation drives bronchial inflammation. Pulmovista offers combined ENT-respiratory management for these patients.
• Gastro-oesophageal reflux disease (GERD): Acid reflux triggers bronchospasm through microaspiration and vagal reflexes. Up to 30–40% of severe asthma patients have clinically significant GERD that worsens their asthma.
• Obstructive sleep apnoea (OSA): OSA causes nocturnal oxygen desaturations and systemic inflammation that significantly worsen asthma — particularly nighttime symptoms. Pulmovista Clinics has access to full sleep study services for OSA diagnosis.
• Obesity: Adipose tissue produces pro-inflammatory cytokines that drive a distinct obesity-associated asthma phenotype — often poorly responsive to standard therapy but amenable to targeted management.
• Anxiety and depression: Psychological comorbidities are highly prevalent in severe asthma and worsen symptom perception, trigger hyperventilation attacks, and reduce adherence to therapy. Pulmovista Clinics refers all appropriate patients for psychological support.
Allergen Immunotherapy for Allergic Severe Asthma
For patients with confirmed allergic severe asthma sensitised to specific allergens (especially house dust mite — the most prevalent allergen in Delhi), allergen immunotherapy (AIT) can modify the underlying allergic disease over 3–5 years — potentially reducing asthma severity and biologic therapy requirements long-term. Pulmovista Clinics offers both subcutaneous immunotherapy (SCIT) injections and sublingual immunotherapy (SLIT) drops, individualised to each patient’s sensitisation profile.
Pulmonary Rehabilitation
Severe asthma significantly impairs exercise capacity and physical conditioning. At Pulmovista Clinics, appropriate patients are referred to a structured pulmonary rehabilitation programme — a supervised, graded exercise and education programme that improves functional capacity, breathlessness perception, and quality of life, independent of lung function changes.
9. Why Pulmovista Clinics Offers the Best Asthma Treatment in Delhi for Hard-to-Control Cases
Patients seeking the best asthma treatment in Delhi for severe or hard-to-control asthma have access to an exceptional level of specialist care at Pulmovista Clinics — a level that is genuinely difficult to find elsewhere in Delhi NCR. Here is what makes Pulmovista the right choice:
1. Specialist expertise in severe asthma: Dr. Dixit Kumar Thakur has dedicated a significant portion of his clinical practice to the assessment and management of severe, difficult-to-treat asthma — including biologic therapy prescription, monitoring, and optimisation.
2. Complete diagnostic infrastructure: On-site spirometry, FeNO testing, full allergy panel testing, and established relationships with premier radiology, sleep study, and pathology partners — all the tests needed for biologic eligibility assessment are accessible through Pulmovista.
3. All five biologic therapies available: Pulmovista Clinics can assess, prescribe, and monitor all five currently approved biologic therapies for severe asthma — Omalizumab, Mepolizumab, Benralizumab, Dupilumab, and Tezepelumab.
4. GINA 2026 compliant protocols: Every treatment decision at Pulmovista is made within the GINA 2026 framework — ensuring patients receive evidence-based, up-to-date care rather than outdated protocols.
5. Holistic, comorbidity-aware care: Dr. Dixit Kumar Thakur evaluates and treats the whole patient — not just the asthma — recognising that comorbidities like rhinitis, GERD, and OSA are often the hidden drivers of poor control.
6. Patient education and empowerment: Every Pulmovista patient receives a written personalised asthma action plan, inhaler technique training, environmental control counselling, and clear instructions for biologic self-injection where applicable.
7. Financial support navigation: The Pulmovista team actively assists eligible patients in accessing patient assistance programmes, insurance pre-authorisation, and cost-reduction pathways for biologic therapy.
8. Continuity of care: Regular structured follow-up appointments, open-access urgent review slots, and a clinical team that knows your case — because severe asthma management is a long-term partnership, not a one-time prescription.
Conclusion: Severe Asthma Is Not a Life Sentence — Pulmovista Clinics Can Help
Severe asthma in Delhi is a serious, complex condition — made harder by one of the world’s most challenging pollution environments. But it is not a life sentence. In 2026, biologic therapies have fundamentally changed what is achievable for patients with hard-to-control asthma, and the evidence is overwhelming: the right biologic, prescribed to the right patient based on a thorough biomarker assessment, can reduce exacerbations by 50–70%, eliminate oral steroid dependence, restore lung function, and give patients their lives back.
At Pulmovista Clinics, Dr. Dixit Kumar Thakur has dedicated his practice to ensuring that Delhi’s severe asthma patients have access to this level of care. If you have been living with uncontrolled asthma — accepting emergency visits, oral steroids, and breathlessness as your normal — please know that there are better options. The best asthma treatment in Delhi for hard-to-control cases is available to you, and it starts with the right specialist assessment.
FAQs-Severe Asthma & Biologic Therapy in Delhi
- How do I know if I qualify for biologic therapy for asthma in Delhi?Biologic therapy is indicated for patients with severe asthma that remains uncontrolled despite high-dose ICS-LABA therapy, and who have experienced 2 or more severe exacerbations in the past year — or who are dependent on oral corticosteroids. Specific biomarker testing (blood eosinophils, total IgE, FeNO) determines which biologic you qualify for. The only way to know definitively is a comprehensive assessment at Pulmovista Clinics with Dr. Dixit Kumar Thakur — the process is straightforward, non-invasive, and typically completed within one or two appointments.
- Are biologic injections painful? What is the administration process?Biologic injections for asthma are subcutaneous — delivered just under the skin, typically in the upper arm, abdomen, or thigh. The injection itself takes only a few seconds and is well tolerated by the vast majority of patients. At Pulmovista Clinics, the first one to three injections are administered by our clinical team with a 30-minute observation period. Many biologics (particularly Dupilumab and Benralizumab on maintenance dosing) can subsequently be self-administered at home using a pre-filled auto-injector pen — similar to an EpiPen. Dr. Dixit Kumar Thakur provides full training before any patient self-injects.
- Can I stop my inhalers once I start biologic therapy?No — biologic therapy is an add-on treatment, not a replacement for inhaled therapy. Most patients continue their ICS-LABA controller inhaler alongside biologic therapy. However, for patients on oral corticosteroids, a supervised, gradual OCS taper is initiated once biologic response is established — typically after 3–4 months. The goal is OCS-free control, not inhaler discontinuation. Dr. Dixit Kumar Thakur manages all OCS tapering carefully at Pulmovista to avoid adrenal insufficiency.
- What happens if a biologic does not work for me?Not all patients respond to every biologic, which is why correct phenotyping before prescription is so important. If a biologic does not produce adequate clinical benefit after 4–6 months of therapy (assessed at Pulmovista Clinics using spirometry, exacerbation rates, and quality-of-life tools), Dr. Dixit Kumar Thakur will review the diagnosis, re-evaluate biomarkers, and consider switching to an alternative biologic or adding further therapy. The absence of response to one biologic does not mean all biologics will fail — the phenotype assessment guides the switch decision.
- Is biologic therapy for asthma available in Delhi outside of specialist centres?Biologic therapies require specialist prescription following a formal biomarker-guided eligibility assessment — they cannot and should not be prescribed by general physicians without this workup. In Delhi NCR, only a small number of specialist respiratory centres have the complete infrastructure to conduct this assessment and manage patients on long-term biologic therapy safely. Pulmovista Clinics, under Dr. Dixit Kumar Thakur, is one of Delhi's dedicated centres for this level of care.
