benralizumab: clinical use

Prescribing considerations

• Initiation should be by a clinician experienced in diagnosing and treating the licensed condition.
• Do not use for acute asthma exacerbations; reassess uncontrolled or worsening disease.
• Reduce corticosteroids only gradually under medical supervision.
• Treat pre-existing helminth infection before starting; consider withholding benralizumab if infection develops and does not respond to treatment.
• Self-administration requires training, hypersensitivity education and clinician selection; patients with a known history of anaphylaxis are excluded from self-administration.
• Active organ-threatening or life-threatening EGPA and active life-threatening HES were not studied.

Contraindications and cautions

• Hypersensitivity to benralizumab or any formulation excipient.

Monitoring

• Assess disease control, severity, blood eosinophils and whether continued treatment remains appropriate.
• Observe and educate for immediate or delayed systemic hypersensitivity reactions.
• Investigate worsening disease.
• Record the product name and batch number for biological traceability.
• Remain alert to helminth infection, particularly when response to antiparasitic treatment is inadequate.

Clinical pharmacology

Benralizumab is an afucosylated humanised IgG1 kappa antibody against IL-5Rα. Enhanced binding to FcγRIII on effector cells promotes antibody-dependent cellular cytotoxicity and eosinophil apoptosis. It is degraded proteolytically rather than through renal clearance or hepatic CYP metabolism.

Formulation and product differences

• The selected product is a single-use pre-filled pen for subcutaneous injection.
• The solution should be clear to opalescent and colourless to yellow; small translucent or white-to-off-white particles may be present.
• Store refrigerated in the original carton and protect from light. It may be kept at room temperature within the product information limits; do not freeze or shake.
• The formulation contains polysorbate 20, which can cause allergic reactions.

Injection

Route: Parenteral

Strengths: 30 mg