biologic

Benralizumab

Fasenra

Route: Subcutaneous
Onset: Near-complete blood eosinophil depletion within 24 hours
Duration: Every 8 weeks after loading

Mechanism of action

Humanized monoclonal antibody against the IL-5 receptor alpha on eosinophils and basophils. Triggers antibody-dependent cell-mediated cytotoxicity, so eosinophils are depleted almost completely rather than just starved of IL-5.

Dosing

Adult: 30 mg SC every 4 weeks for the first 3 doses, then every 8 weeks
Pediatric: Age 6–11: 10 mg (<35 kg) or 30 mg (≥35 kg) on the same schedule

Indications

Severe eosinophilic asthma as add-on maintenance (age ≥6)
Eosinophilic granulomatosis with polyangiitis

Contraindications

Hypersensitivity to benralizumab
Not for acute bronchospasm

Side effects

Headache
Pharyngitis
Injection-site reactions
Hypersensitivity reactions

Monitoring parameters

Exacerbations and oral corticosteroid use
Treat helminth infections before starting

Drug interactions

None clinically significant

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