Duration of Benralizumab Treatment
Benralizumab should be administered at 30 mg subcutaneously every 4 weeks for the first three doses, then every 8 weeks thereafter as a long-term maintenance therapy for patients with treatment-dependent conditions requiring eosinophil depletion. 1
Dosing Schedule and Administration
- Benralizumab is administered as a 30 mg subcutaneous injection every 4 weeks for the first three doses, then transitions to every 8 weeks for maintenance therapy 2, 1
- This dosing schedule has been established as effective in maintaining eosinophil depletion while minimizing injection frequency 3
- For treatment-dependent conditions like allergic bronchopulmonary aspergillosis (ABPA), benralizumab is recommended as a long-term therapy option 2
Duration of Treatment Based on Condition
For Allergic Bronchopulmonary Aspergillosis (ABPA)
- For treatment-dependent ABPA, benralizumab is recommended as a long-term maintenance therapy option with no specified endpoint 2
- Patients with treatment-dependent ABPA often require ongoing biological therapy to maintain remission and prevent exacerbations 2
- Long-term use of benralizumab has been shown to be effective in maintaining response in 74% of patients with hypereosinophilic disorders at 48 weeks 2
For Severe Eosinophilic Asthma
- Long-term safety and efficacy data support continued use of benralizumab for at least 2 years in severe eosinophilic asthma 3
- No new consequences of long-term eosinophil depletion were observed after 2 years of treatment, supporting extended use 3
- Treatment should be continued as long as clinical benefit is maintained, as discontinuation may lead to return of symptoms and exacerbations 4
For Eosinophilic Granulomatosis with Polyangiitis (EGPA)
- For EGPA, benralizumab is recommended as ongoing therapy to maintain remission and allow reduction in oral corticosteroid dose 1, 5
- Real-world data shows that patients with EGPA maintained on benralizumab for at least 12 months demonstrated significant reduction in exacerbations and oral corticosteroid requirements 5
Monitoring During Treatment
- Regular assessment of clinical response should be conducted every 3-6 months 2
- Therapeutic drug monitoring is recommended when using benralizumab 1
- Efficacy should be evaluated based on:
Safety Considerations for Long-term Use
- Long-term safety data from the BORA extension trial (up to 2 years) showed no new safety concerns with extended benralizumab use 3
- The most common adverse events during long-term treatment include viral upper respiratory tract infections (14-16%) and worsening asthma (7-10%) 3
- No evidence of increased opportunistic infections or other consequences of prolonged eosinophil depletion have been observed 3
Conclusion on Treatment Duration
Benralizumab therapy should be continued long-term in patients who demonstrate clinical benefit, with regular monitoring of response. Unlike some treatments that have defined endpoints, benralizumab is typically used as a maintenance therapy for chronic eosinophilic conditions with no predetermined duration of treatment, particularly for treatment-dependent conditions like ABPA or severe eosinophilic asthma.