How it is administered

Benralizumab is administered as a subcutaneous injection. It is available in prefilled syringes and autoinjectors, with dosages tailored to the patient's age, weight, and condition. For adults and adolescents (12 years and older) with asthma or eosinophilic granulomatosis with polyangiitis (EGPA), the typical dose is 30 mg every 4 weeks for the first 3 doses, then every 8 weeks thereafter (for asthma) or every 4 weeks (for EGPA). For children aged 6 to 11 years with asthma, the dosage is based on body weight: 10 mg for those under 35 kg and 30 mg for those 35 kg or more, following the same schedule as adults. Injections can be given in the thigh, abdomen, or upper arm (if administered by a caregiver or healthcare provider).

How it works

Benralizumab is a humanized monoclonal antibody that targets the interleukin-5 receptor alpha subunit (IL-5Rα) found on eosinophils and basophils, which are types of white blood cells involved in inflammation. By binding to IL-5Rα, benralizumab attracts natural killer (NK) cells, which then destroy eosinophils and basophils through a process called antibody-dependent cell-mediated cytotoxicity (ADCC).

Eosinophils play a significant role in the inflammation seen in certain diseases, such as severe asthma with an eosinophilic phenotype and EGPA. By reducing the number of eosinophils in the blood and tissues, benralizumab helps decrease inflammation and the symptoms associated with these conditions. The medication does not provide immediate relief for acute symptoms but works over time to reduce exacerbations and the need for oral corticosteroids.

Who Should take it

Benralizumab is intended for:

• Adults and children aged 6 years and older with severe asthma that has an eosinophilic phenotype, as an add-on maintenance treatment. This means it is used in addition to other asthma medications when asthma remains uncontrolled.
• Adults with eosinophilic granulomatosis with polyangiitis (EGPA), a rare disease characterized by inflammation of blood vessels and high levels of eosinophils.

It is not meant for the relief of acute asthma attacks or sudden breathing problems. Patients who have frequent asthma exacerbations despite high-dose inhaled corticosteroids and other controller medications may benefit from benralizumab. For EGPA, it is used to help control disease activity and reduce the need for oral corticosteroids.

Who should not take it

Benralizumab should not be used by patients who have a known hypersensitivity or allergy to benralizumab or any of its ingredients. Signs of hypersensitivity can include anaphylaxis, angioedema, urticaria (hives), and rash.

It is also important to treat any existing parasitic (helminth) infections before starting benralizumab, as the medication may affect the body's ability to fight these infections. If a patient develops a parasitic infection while on benralizumab and does not respond to standard treatment, the medication should be discontinued until the infection resolves.

Benralizumab is not indicated for the treatment of acute asthma symptoms or status asthmaticus (severe, life-threatening asthma attacks).

Commonly used with

Benralizumab is used as an add-on therapy, meaning it is taken in addition to other asthma or EGPA medications. These may include inhaled corticosteroids, long-acting beta agonists, oral corticosteroids, and other controller medications.

Patients should continue their existing asthma or EGPA treatments unless instructed otherwise by their healthcare provider. Benralizumab may help reduce the need for oral corticosteroids over time.

Commonly tested with

Benralizumab has been tested in combination with standard asthma therapies such as inhaled corticosteroids, long-acting beta agonists, and oral corticosteroids. In EGPA, it has been studied alongside background therapies like prednisolone/prednisone and, in some cases, immunosuppressive agents (such as azathioprine, methotrexate, or mycophenolic acid).

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