Asthma and biologics

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Wolf6

PEB Forum Regular Member
Registered Member
Has anybody had any experience with MEB/PEB and being placed on a biologic for asthma? Was it considers an immunosuppressant?

Also, my initial diagnosis for EIA came in 2016 with an FEV/FEV-1 of 53%. If I am placed on a biologic, sent to a med board, then retested, i would imagine my FEV would improve thus reducing my rating…thoughts?
 
Wolf6 said:
Has anybody had any experience with MEB/PEB and being placed on a biologic for asthma? Was it considers an immunosuppressant?

Also, my initial diagnosis for EIA came in 2016 with an FEV/FEV-1 of 53%. If I am placed on a biologic, sent to a med board, then retested, i would imagine my FEV would improve thus reducing my rating…thoughts?
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If you are being treated with a biologic, it will be treated as an immunosuppressant for rating purposes. If you are on a continuous regimen- in other words, you are not going off it for a few months and then back on- then you will meet the 100% rating criteria under VA Code 6602 irrespective of your PFT results.
 
This is very similar to my situation, and I was wondering about the biologics as well. I see that sometimes a website classifies them as immunosuppressants, and other times they don't. I've been on Tezspire since August, and there are no plans to take me off of it. My C&P exam for that is next week. I appreciate your input, johnbgately; your're convinced it's classified that way?
 
I am on a biologic for asthma and awaiting PEB results. I will let you know the outcome when I get it.
 
I’ll do the same if I finish first. I just finished my exams, so it could be a little while.
 
I received my exam DBQs from my PEBLO, and I don't see anything mentioning biologics in the the exam questions. Maybe the rater will see what we're taking and make note of it, but I'm not holding my breath on that.
 
Mine was the same way. It's with the rater now, so when I get results I will post them.
 
My proposed rating came back, and it has 0 for asthma. I think there was a mistake, but I still rated 100% so I don't think I should say anything about it. Biologics and the 20% FEV-1 had no impact on getting a rating. I really think they just missed it, so I'm not much help.
 
That was a quick turnaround. I am glad your overall was 100, but very strange that your asthma was only rated 0 while on biologics.
 
I was really planning on 100% just for asthma between the FEV-1 scores and the biologic. Something went really off there. I'm afraid if I try to fight that, I might open everything back up and lose the 100 I already have. I don't think the gamble is worth it.
 
That’s weird my referred condition is asthma as well currently 73 days waiting on findings to come back and been on biologic for long time now I really hope they don’t mess it up because asthma is suppose to be rated 100 when you are on Biologics. Honestly if it was me I’d bring it up with your attorney.
 
What is it that makes us think the biologics are due 100%?
There is no mention of them specifically in the CRF, unless your rater considers them an immunosuppressant. Mine obviously did not.
 
The criteria for assigning an asthma VA rating is as follows:

  • 10% — For this rating, a veteran must show a predicted FEV-1 of 71-80%; an FEV-1/FVC ratio of 71-80%; or a need for intermittent inhalational or oral bronchodilator therapy
  • 30% — For this rating, a veteran must show a predicted FEV-1 of 56-70%; an FEV-1/FVC ratio of 56-70%; a need for daily inhalational or oral bronchodilator therapy; or a need for inhalational anti-inflammatory medication
  • 60% — For this rating, a veteran must show a predicted FEV-1 of 40-55%; an FEV-1/FVC ratio of 40-55%; physician visits at least once a month for required care of symptom exacerbations; or intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids
  • 100% — For this rating, a veteran must show a predicted FEV-1 of less than 40%; an FEV-1/FVC ratio less than 40%; more than one asthma attack per week with episodes of respiratory failure; or daily use of systemic (oral or parenteral) high dose corticosteroids or immunosuppressive medications.

I was put on Tezspire injections by an Immunologist and I specially asked him if it was a immunosuppressant and he said yes. If you look up the drug class it falls under it says the same thing.
 
My doctor said no, it's not an immunosuppressant, but I have decided to run the VARR. We filed an extension today and hope to have it completed next week. Maybe two weeks after that I'll have a definitive answer for everyone.
 
VA is all about following the rating criteria. Biologics for Asthma are all considered monoclonal antibodies, not immunosuppressive. I don't think biologics play any roll in considering ratings. For all our sakes, I wish it did. I guess we will see after your VARR retanner.
 
My DoD rating for asthma was 60%. Biologics played no roll in ratings as predicted. I hope this helps other folks who are questioning how Biologics affect VA ratings for Asthma.
 
I am facing an MEB for ongoing respiratory issues. Diagnosed with mild asthma through a methacholine challenge, but Dyspnea symptoms post-COVID were the primary driver of the study. Asthma is the diagnosis, but it’s not the primary issue. My FEV1 %Predicted is 99, and my FEV1/FVC is 87. I’m on daily-use of Dulera which is a corticosteroid. Am I reading this correctly that I would not have a DoD rating according to VA standards?
 
Asthma biologics update...first off, I made it to Retirement finally...30Aug23!

I ended up having another anaphylactic reaction to Dupixent and will be trying Tezspire next week. Hopefully it goes well. Also, no luck getting VA to recognize immunomodulators/monoclonal antibodies as immunosuppressive drugs....I will just keep pressing the issue. Good luck to the rest of you out there fighting the same battle.
 
All Tezspire / Xolair are immunosuppresants and warrant a 100 percent rating. You can google Tezspire and under drugs.com it is listed as an immunosuppresant like Xolair is. Also, Google VA disability Xolair asthma and you'll see other bets getting a 100 percent rating from the board. You will just have to appeal it to that level. Johnbgately said it spot on above!!
 
rolling842000 said:
All Tezspire / Xolair are immunosuppresants and warrant a 100 percent rating. You can google Tezspire and under drugs.com it is listed as an immunosuppresant like Xolair is. Also, Google VA disability Xolair asthma and you'll see other bets getting a 100 percent rating from the board. You will just have to appeal it to that level. Johnbgately said it spot on above!!
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This is not totally true. As of 2024, there are only 6 biologics used to treat asthma. xolair, nucala, fasenra, cinqair, dupixent and tezspire. As someone stated above, the va is all about following the rating criteria.

Out of the 6 biologics, only one is listed as an "immune suppressant" drug classification on the va formulary advisor (resource the va uses to search for formulary drug info) - which is xolair. The other 5 are listed under drug class "anti-asthma", "respiratory agent" and "dermotologicals".

I've only seen one or two BVA cases (which you shouldn't quote in your appeals/hlr to the va since every case is different) that granted 100% due to use of biologic. And that was due to xolair.

Im currently in the beginning stages of the MEB for asthma and Im on nucala so hopefully they change their ways.


Xolair VA Formulary Advisor VA Formulary Advisor
Tezspire VA Formulary Advisor VA Formulary Advisor
Nucala VA Formulary Advisor VA Formulary Advisor
 
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