Reslizumab

Aka: Reslizumab, Cinqair

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II. Indications

  1. See Asthma Monoclonal Antibody
  2. Third-line agents for refractory, Type 2 Asthma (Allergic Asthma or Eosinophilic Asthma, represents 50% of Asthma)
    1. Despite long acting Bronchodilator and Inhaled Corticosteroids
  3. One of the following findings present
    1. Blood Eosinophils >150/uL
    2. Sputum Eosinophils >2%
    3. Ferrous Nitrous Oxide >20 parts per billion
    4. Maintenance oral Corticosteroids required

III. Mechanism

  1. Interleukin-5 Antagonist (alpha-directed cytolytic Monoclonal Antibody, IgG4 Kappa)
  2. Binds Interleukin 5 receptor on Eosinophils and Basophils (Asthma-related inflammatory cells)
    1. Marks these inflammatory cells for Natural Killer Cell mediated death

IV. Dosing

  1. May be used in age >=18 years old
  2. Dose 3 mg/kg IV infusion over 20 to 50 minutes every 4 weeks

V. Adverse Effects

  1. See Asthma Monoclonal Antibody
  2. Uncommon
    1. Pharyngitis (2%)
    2. Anaphylaxis (0.2%)
      1. Observe first dose by health care professional (as done with Omalizumab)

VI. Resources

  1. Biologic Therapy in Asthma
    1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5405559/
  2. Reslizumab (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=053b9158-2a5b-48b9-bf47-5fa78a35ec33

VII. References

  1. (2022) Comparison of Asthma Medications, Presc Lett, #381217
  2. (2020) Drugs for Asthma, Med Lett Drug Ther 62: 193-200
  3. (2018) Biologics for Asthma, Presc Lett
  4. Nair (2017) N Engl J Med 376(25): 2448-58 [PubMed]
  5. Narasimhan (2021) Am Fam Physician 103(5): 286-90 [PubMed]
  6. Raymond (2023) Am Fam Physician 107(4): 358-68 [PubMed]

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