How it is administered

Benralizumab is administered as a subcutaneous injection. It comes in prefilled syringes or autoinjectors, with doses of 10 mg and 30 mg. The injection is typically given in the thigh, abdomen, or upper arm. For adults and adolescents (12 years and older), the recommended dose is 30 mg every 4 weeks for the first 3 doses, then every 8 weeks. For children aged 6-11 years, dosing depends on body weight: 10 mg if under 35 kg, or 30 mg if 35 kg or more, following the same schedule. For eosinophilic granulomatosis with polyangiitis (EGPA), the recommended dose is 30 mg every 4 weeks.

How it works

Benralizumab is a humanized monoclonal antibody that targets the alpha subunit of the interleukin-5 receptor (IL-5Rα) found on the surface of eosinophils and basophils. By binding to this receptor, benralizumab attracts immune cells called natural killer (NK) cells, which then destroy eosinophils and basophils through a process called antibody-dependent cell-mediated cytotoxicity (ADCC). Eosinophils are a type of white blood cell involved in inflammation and are often elevated in certain blood cancers and diseases like asthma and EGPA.

By reducing the number of eosinophils, benralizumab helps to control inflammation and symptoms associated with diseases where eosinophils play a key role. The reduction in eosinophils is rapid and sustained, with blood levels dropping significantly after the first dose and remaining low throughout treatment. This mechanism is particularly useful in conditions where high eosinophil counts contribute to disease activity.

Who Should take it

Benralizumab is indicated for:

• Add-on maintenance treatment of adults and children aged 6 years and older with severe asthma and an eosinophilic phenotype.
• Treatment of adult patients with eosinophilic granulomatosis with polyangiitis (EGPA).

It is not approved specifically for chronic eosinophilic leukemia, but may be considered in cases where high eosinophil counts are a significant concern and other indications overlap. Patients who have not achieved adequate control of their symptoms with standard therapies, or who require frequent oral corticosteroids, may benefit from benralizumab as part of their treatment plan. Always consult your healthcare provider to determine if this medication is appropriate for your specific condition.

Who should not take it

Benralizumab should not be taken by individuals who have known hypersensitivity to benralizumab or any of its ingredients. Signs of hypersensitivity can include anaphylaxis, angioedema, urticaria, or rash.

It is also not intended for the relief of acute bronchospasm or status asthmaticus, so it should not be used to treat sudden asthma attacks or rapidly worsening symptoms. Patients with active helminth (parasitic worm) infections should be treated for the infection before starting benralizumab. If a patient develops a helminth infection during treatment and does not respond to standard therapy, benralizumab should be discontinued until the infection is resolved.

Commonly used with

Benralizumab is often used alongside other standard treatments for asthma or EGPA, such as inhaled corticosteroids, long-acting beta agonists, and sometimes oral corticosteroids. It is typically added when these treatments alone are not sufficient to control symptoms.

It may also be used with immunosuppressive therapies in certain conditions, as directed by your healthcare provider.

Commonly tested with

In clinical studies, benralizumab has been tested in combination with standard background therapies for asthma and EGPA, including inhaled corticosteroids, long-acting beta agonists, and oral corticosteroids. In the MANDARA trial for EGPA, it was compared directly to mepolizumab, another monoclonal antibody targeting eosinophils.

No formal drug-drug interaction studies have been conducted, but commonly co-administered medications have not shown to affect benralizumab’s clearance or effectiveness.