Benralizumab is used to treat eosinophilic asthma.

Brand name Fasrenra.

A humanized recombinant monoclonal antibody of the isotype IgG1k immunoglobulin that specifically binds to the alpha chain of the interleukin 5 receptor (IL-5R) expressed on eosinophils and basophils.

It inhibits the binding of IL-5 thus blocking, signal transduction. 

It high affinity for the FcγRIIIα receptor in natural killer cells, macrophages and neutrophils.

Benralizumab is indicated as a maintenance treatment of patients 12 years or older with severe asthma and an eosinophilic phenotype.

Patients with this phenotype are characterized by the expression of IL-5 and IL-13, airway hyperresponsiveness, responsiveness to inhaled corticosteroids, high serum IgE and eosinophilia in blood and airway. 

In the TH2-high phenotype, eosinophilic asthma, IL-5 presents a central role as it is responsible for eosinophil differentiation, survival, activation and migration to the lungs.

Eosinophils are the key target of inflammatory respiratory diseases and they undergo apoptosis in absence of IL-5. 

Benralizumab’s action on the IL-5 receptor in basophils and eosinophils produces the apoptosis and its significant reduction in the blood.

The binding of benralizumab to natural killer cells FcγRIIIα receptor produces a direct antibody-dependent cell-mediated cytotoxicity. 

The combination of these effects produce a reduction in eosinophil count in airway mucosa, submucosa, sputum, blood and bone marrow.

Interleukin-5 (IL-5) induces an eosinophil-mediated inflammatory response by binding to the IL-5 receptor (IL-5R) expressed in eosinophils, basophils and some mast cells. 

Benralizumab is an afucosylated antibody in the CH2 region which gives it a high affinity for the FcγRIIIa on natural killer cells, macrophages and neutrophils, magnifying apoptosis response in eosinophils via antibody-dependent cell-mediated cytotoxicity.

The administration of 20-200 mg presents an absorption half-life of 3.6 days with a bioavailability of 58%.

Benralizumab has a volume of distribution in a range of 52-93ml/kg. 

It is degraded by proteases widely spread in the body. 

Benraluzimab presents a linear pharmacokinetic without target-receptor mediated clearance.

Has a rapid depletion of the target and an elimination mainly mediated through the reticuloendothelial system.

The half-life of Benralizumab is estimated to be 15-18 days.

There are not reports of long-term regarding tumorgenesis or carcinogenesis. 

Fertility studies performed in aminal trials showed no adverse histopathological findings.

The risk or severity of adverse effects can be increased when Abciximab

Adalimumab,Aducanumab, Alemtuzumab, Alirocumab, Amivantamab, Anifrolumab, Ansuvimab, Anthrax immune globulin human, Antilymphocyte immunoglobulin (horse), is combined with Benralizumab.

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