The clinical profile of benralizumab in the management of severe eosinophilic asthma

Abstract

Despite several therapeutic choices, 10-20% of patients with severe uncontrolled asthma do not respond to maximal best standard treatments, leading to a healthcare expenditure of up to 80% of overall costs for asthma. Today, there are new important therapeutic strategies, both pharmacological and interventional, that can result in improvement of severe asthma management, such as omalizumab, bronchial thermoplasty and other biological drugs, for example, mepolizumab, reslizumab and benralizumab. The availability of these new treatments and the increasing knowledge of the different asthmatic phenotypes and endotypes makes correct patient selection increasingly complex and important. In this article, we discuss the features of benralizumab compared with other anti-interleukin-5 biologics and omalizumab, the identification of appropriate patients, the safety profile and future developments.

Keywords: anti-interleukin-5 monoclonal antibodies; benralizumab; biomarkers; cytokines; eosinophils; interleukin 5; severe asthma.

Figure 1.

Benralizumab binds with the α chain of interleukin 5 receptor (IL-5R) resulting in inhibition of hetero-oligomerization of α and β subunits and thus no signal transduction occurs. Afucosylated site of benralizumab enhances its binding to FcγRIIIa leading to antibody-dependent cell-mediated cytotoxicity (ADCC).