II. Indications
- See Asthma Monoclonal Antibody
- Third-line agents for refractory, Type 2 Asthma (Allergic Asthma or Eosinophilic Asthma, represents 50% of Asthma)
- Despite long acting Bronchodilator and Inhaled Corticosteroids
- One of the following findings present
- Blood Eosinophils >150/uL
- Sputum Eosinophils >2%
- Ferrous Nitrous Oxide >20 parts per billion
- Maintenance oral Corticosteroids required
III. Precautions
- Treat Helminth infections prior to starting therapy
IV. Dosing
- May be used in age >=12 years old U.S. (>=18 years old Canada)
- Dose 30 mg SQ every 4 weeks for 3 doses, then every 8 weeks
- Subcutaneous (SQ) injection sites include upper arm, Abdomen and thigh
V. Mechanism
-
Interleukin-5 Antagonist (alpha-directed cytolytic Monoclonal Antibody, IgG1 Kappa)
- Similar to Mepolizumab
- Binds Interleukin 5 receptor on Eosinophils and Basophils (Asthma-related inflammatory cells)
- Marks these inflammatory cells for Natural Killer Cell mediated death
VI. Safety
- Unknown safety in pregnancy
- Unknown safety in Lactation
VII. Adverse Effects
- See Asthma Monoclonal Antibody
- Fever
- Headache (8%)
- Pharyngitis (5%)
VIII. Resources
- Biologic Therapy in Asthma
- Benralizumab (DailyMed)
IX. References
- (2022) Comparison of Asthma Medications, Presc Lett, #381217
- (2020) Drugs for Asthma, Med Lett Drug Ther 62: 193-200
- (2018) Biologics for Asthma, Presc Lett
- Narasimhan (2021) Am Fam Physician 103(5): 286-90 [PubMed]
- Raymond (2023) Am Fam Physician 107(4): 358-68 [PubMed]