Benralizumab

How it works

It binds the interleukin-5 receptor alpha subunit on eosinophils and, by engaging natural killer cells, induces their rapid depletion, reducing eosinophilic airway inflammation.

Prescribing in practice

• Hypersensitivity reactions including anaphylaxis can occur, so administer where these can be recognised and managed.
• It is given by subcutaneous injection and is for maintenance, not acute exacerbations or bronchospasm.
• Any pre-existing helminth infection should be treated before starting, as eosinophils contribute to parasite defence.

Monitoring

Monitor for hypersensitivity reactions after dosing and review asthma control and exacerbation frequency over time.

Counselling the patient

• This injection is an add-on and does not replace your inhalers.
• Report rash, swelling or breathing difficulty after an injection.
• Do not stop your other asthma medicines unless advised.

Evidence & guidelines

NICE recommends benralizumab as an option for severe eosinophilic asthma within defined eligibility criteria.