Pulmonology Book


Asthma Monoclonal Antibody

Aka: Asthma Monoclonal Antibody, Asthma Biologic, Benralizumab, Fasenra, Mepolizumab, Nucala, Reslizumab, Cinqair
  1. See Also
    1. Severe Persistent Asthma
    2. Omalizumab (Xolair)
  2. Indications
    1. Third-line agents for inadequately controlled severe Eosinophilic Asthma
      1. Despite long acting Bronchodilator and Inhaled Corticosteroids
  3. Adverse Effects
    1. Anaphylaxis risk with all agents (several of the agents have a reported 0.2% risk)
      1. Consider prescribing Epinephrine injector
  4. Disadvantages
    1. $2500 to $4500 per month
  5. Preparations: Interleukin-5 Antagonist (alpha-directed cytolytic Monoclonal Antibody, IgG1 Kappa)
    1. General
      1. May be used in age >=12 years old U.S. (>=18 years old Canada)
    2. Benralizumab (Fasenra)
      1. Dose 30 mg SQ every 4 weeks for 3 doses, then every 8 weeks
      2. Uncommon Headache, Pharyngitis
    3. Mepolizumab (Nucala)
      1. Dose 100 mg SQ q 4 weeks
      2. Common Headache, uncommon injection site irritation, back pain ,Fatigue
  6. Preparations: Interleukin-5 Antagonist (Monoclonal Antibody, IgG4 Kappa)
    1. General
      1. May be used in age >=18 years old
    2. Reslizumab (Cinqair)
      1. Dose 3 mg/kg IV infusion over 20-50 min every 4 weeks
      2. Uncommon Pharyngitis
  7. Preparations: Anti-IgE Antibody
    1. General
      1. May be used in age >=6 years old (if positive skin test or RAST to perennial allergen)
    2. Omalizumab (Xolair)
      1. Dose 75 to 375 mg SQ every 2-4 weeks (variable dose based on age, weight, serum IgE)
      2. Uncommon Arthralgias
  8. Resources
    1. Biologic Therapy in Asthma
      1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5405559/
  9. References
    1. (2018) Biologics for Asthma, Presc Lett

mepolizumab (C0969324)

Concepts Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) , Immunologic Factor (T129)
MSH C434107
English mepolizumab
Derived from the NIH UMLS (Unified Medical Language System)

reslizumab (C1869620)

Concepts Immunologic Factor (T129)
MSH C515492
English reslizumab
Derived from the NIH UMLS (Unified Medical Language System)

benralizumab (C2982078)

Definition (NCI) An afucosylated, humanized monoclonal antibody against the alpha chain of the interleukin-5 receptor (IL-5Ra), with potential anti-asthmatic activity. Upon administration, benralizumab binds to IL-5Ra and elicits an antibody-directed cell cytotoxicity (ADCC) against IL-5Ra-expressing cells. This induces apoptosis in IL-5Ra-expressing cells and may reduce asthmatic episodes. IL-5Ra, expressed on both eosinophils and basophils, plays a key role in asthma.
Concepts Immunologic Factor (T129) , Pharmacologic Substance (T121)
MSH C571386
English BIW-8405, Anti-CD125 Humanized Monoclonal Antibody, IgG1-kappa, KHK-4563, Benralizumab, MEDI-563, benralizumab, BENRALIZUMAB
Derived from the NIH UMLS (Unified Medical Language System)

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