Fasenra

Brand name: fasenra
Generic name: benralizumab
Dosage form: injection for subcutaneous use
Drug class: Interleukin inhibitors

Fasenra (benralizumab) is a cutting-edge biologic therapy used primarily to manage severe eosinophilic asthma. In this condition, high levels of eosinophils (a type of white blood cell) lead to chronic inflammation in the airways. Developed by AstraZeneca, Fasenra is part of a growing class of biological medications designed to target specific immune system components, offering a more personalized approach to treating asthma that is difficult to control with traditional medicines.

Overview of Fasenra

Fasenra is a monoclonal antibody that targets the IL-5 receptor found on the surface of eosinophils. By binding to this receptor, Fasenra helps reduce the production and survival of eosinophils in the bloodstream and tissues. This reduction in eosinophils can lead to decreased inflammation and better asthma control for people with eosinophilic asthma, a subtype of asthma that accounts for about 5-10% of all asthma cases.

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Unlike traditional asthma treatments like inhaled corticosteroids and bronchodilators, which focus on managing symptoms, Fasenra addresses the root cause of inflammation by targeting eosinophils. This makes it especially useful for patients whose asthma symptoms persist despite using high doses of corticosteroids or other controller medications.

Uses of Fasenra

Severe Eosinophilic Asthma

Fasenra is FDA-approved for treating severe eosinophilic asthma in adults and adolescents aged 12 and older. This is its most common use, and it has been shown to reduce asthma exacerbations (flare-ups), improve lung function, and reduce the need for oral corticosteroids in these patients.

Chronic Rhinosinusitis with Nasal Polyps

Fasenra may also be used off-label to treat patients with chronic rhinosinusitis with nasal polyps. In these patients, eosinophils contribute to persistent inflammation and the growth of polyps, leading to breathing difficulties and sinus infections.

Hypereosinophilic Syndrome (HES)

Hypereosinophilic syndrome is a rare condition where the body produces too many eosinophils, leading to inflammation and damage in various organs, such as the heart, lungs, and skin. Although not FDA-approved for this use, Fasenra may be prescribed off-label to help manage this condition by lowering eosinophil levels.

Eosinophilic Granulomatosis with Polyangiitis (EGPA)

EGPA, formerly known as Churg-Strauss syndrome, is a rare autoimmune condition where eosinophils cause inflammation in the blood vessels. While Fasenra is not specifically approved for EGPA, some doctors use it off-label to manage this challenging condition.

Atopic Dermatitis (off-label)

Although still being researched, Fasenra shows promise in treating atopic dermatitis (eczema), particularly in patients with elevated eosinophil counts. By targeting eosinophils, Fasenra may help reduce skin inflammation and itching, though more studies are needed to confirm its effectiveness.

Warnings for Fasenra

Allergic Reactions

As with any injectable medication, Fasenra carries a risk of allergic reactions. Some patients may experience a severe allergic reaction, known as anaphylaxis, which can include symptoms such as difficulty breathing, swelling of the face or throat, and hives. Immediate medical attention is required if these symptoms occur.

Parasitic Infections

Eosinophils play a role in fighting parasitic infections. By reducing eosinophil levels, Fasenra may make patients more susceptible to these infections. If you live in or plan to travel to areas with common parasitic infections, talk to your doctor about the potential risks.

Immune System Suppression

While Fasenra does not broadly suppress the immune system, it affects eosinophils, part of the body’s immune response. As a result, patients may be more vulnerable to infections, and any signs of infection, such as fever or persistent cough, should be promptly reported to a healthcare provider.

Herpes Zoster (Shingles)

Some patients receiving monoclonal antibody treatments, including Fasenra, have reported reactivation of the herpes zoster virus (shingles). This condition can cause painful rashes and other complications. If you’ve had chickenpox or the shingles virus, inform your doctor before starting Fasenra.

Pregnancy and Breastfeeding

Fasenra’s safety during pregnancy and breastfeeding has not been thoroughly studied. If you are pregnant or planning to become pregnant, or if you are breastfeeding, you should discuss the potential risks and benefits of using Fasenra with your healthcare provider.

Before Taking Fasenra

Current Medications

Provide a complete list of all prescription, over-the-counter medications, vitamins, and supplements you currently take. Some drugs may interact with Fasenra, potentially reducing its effectiveness or increasing the risk of side effects.

Vaccination History

You should avoid receiving live vaccines (such as the measles, mumps, and rubella vaccine). At the same time, on Fasenra, as the medication may reduce your immune system’s ability to respond to the vaccine. Your doctor may recommend getting vaccinated before starting treatment.

Infection History

Let your doctor know if you have a history of recurrent or current infections. Fasenra may increase the risk of certain infections, particularly parasitic infections.

Chronic Health Conditions

If you have other chronic health conditions, such as autoimmune diseases or cardiovascular problems, it is essential to discuss these with your healthcare provider before starting Fasenra.

Pregnancy and Family Planning

Women who are pregnant, planning to become pregnant, or breastfeeding should consult with their doctor to evaluate the risks and benefits of using Fasenra during these stages.

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Dosage Information for Fasenra

For the first three doses, Fasenra is administered as a 30 mg subcutaneous injection every four weeks. After the initial three doses, the medication is administered once every eight weeks. Fasenra is typically given in a healthcare setting by a healthcare professional. However, some patients may be trained to self-administer the medication at home using pre-filled syringes or an autoinjector.

Side Effects of Fasenra

1. Headache: One of the most frequently reported side effects of Fasenra is a headache, which is usually mild to moderate in intensity.
2. Fever: Some patients experience a low-grade fever following Fasenra injections. This is typically short-lived and can be managed with acetaminophen or ibuprofen.
3. Sore Throat: Upper respiratory tract infections, including sore throat, can occur in some patients taking Fasenra.
4. Injection Site Reactions: Mild redness, swelling, or pain at the injection site is common after Fasenra administration.
5. Fatigue: Some patients report feeling fatigued after receiving Fasenra. This side effect is typically mild and disappears as the body adjusts to the medication.

Interactions with Fasenra

Corticosteroids

Fasenra is often used to reduce the need for oral corticosteroids in patients with severe asthma. If you are taking steroids, your doctor may gradually lower your dose as your asthma improves with Fasenra.

Other Biologic Therapies

Combining Fasenra with other biologics (such as omalizumab or dupilumab) may increase the risk of immune system-related side effects. Always inform your healthcare provider if you are using another biologic.

Immunosuppressive Medications

Fasenra may increase the risk of infections in patients taking immunosuppressive medications. These include drugs for treating autoimmune diseases, organ transplants, or cancer.

Live Vaccines

As mentioned earlier, live vaccines should be avoided while on Fasenra due to the risk of an inadequate immune response. Non-live vaccines, such as the flu shot, are generally safe and recommended.

Herbal Supplements

Some herbal supplements, such as echinacea or St. John’s wort, may interact with Fasenra and affect its effectiveness. Always consult your doctor before using any supplements.

How Fasenra Compares to Other Asthma Medications

Several biological therapies are available for treating severe asthma, each with its target and mechanism of action. Fasenra is unique because it specifically targets eosinophils by binding to the IL-5 receptor. Other biologics, such as mepolizumab (Nucala) and reslizumab (Cinqair), also target IL-5 but do so differently. One key advantage of Fasenra is its convenient dosing schedule. Injections are required only once every eight weeks after the initial loading phase, which can be more convenient for patients than other biologics that require more frequent dosing.

Also Read: Dealing with Allergies: Symptoms, Treatment & Management

Conclusion

Fasenra represents a significant advancement in treating severe eosinophilic asthma and other eosinophil-driven conditions. Its ability to target the underlying cause of inflammation, combined with its relatively low dosing frequency, makes it an attractive option for patients who have struggled to control their asthma with traditional treatments.

FAQs

Can Fasenra cure asthma?

Fasenra cannot cure asthma, but it can significantly reduce symptoms and the frequency of asthma attacks in patients with severe eosinophilic asthma. Most patients experience a notable improvement in their asthma control.

How long does it take for Fasenra to work?

Many patients start to see improvements in their asthma symptoms within a few weeks of beginning Fasenra. However, the full benefits may take several months to become apparent.

Does insurance cover Fasenra?

Fasenra is often covered by insurance, but coverage varies by plan. Your healthcare provider can work with your insurance company to determine your specific coverage and any out-of-pocket costs.

Can I stop taking my inhaler while on Fasenra?

Fasenra is not replacing your rescue inhaler or other daily asthma medications. You should continue using your prescribed asthma medications unless your doctor advises otherwise.

What happens if I miss a dose of Fasenra?

If you miss a scheduled dose, contact your healthcare provider to reschedule your injection. Missing a dose may reduce the effectiveness of the treatment, so it’s crucial to stay on schedule.