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