Getting Started with Fasenra for Eosinophilic Asthma

1. Getting Started with Fasenra for Eosinophilic Asthma Asthma ranks first among the most prevalent chronic respiratory conditions worldwide. In the past 25 years, the number of people living with asthma has risen by nearly 13%, and today, it affects more than 300 million people across the globe. Asthma-related deaths have declined due to advances in treatment.1 However, asthma continues to pose significant health challenges – particularly for patients with severe or poorly controlled forms of the disease that do not respond well to standard therapies.2 Asthma comes in different form, or phenotypes, based on the underlying causes, symptoms, and treatment responses. One common feature in certain types – particularly eosinophilic asthma – is the role of eosinophils, a type of white blood cells that contribute to inflammation in the airways.1 What is eosinophilic asthma? Eosinophilic asthma is a specific subtype of asthma caused by high levels of eosinophils in the blood and airways.1 These cells play an important role in the body’s immune system, but in this form of asthma, they become overactive and trigger inflammation in the lungs.3 It is estimated that around 50%-60% of patients with severe asthma have this eosinophilic subtype. When eosinophils are activated, they can lead to1 • • • • inflammation of the airways excess mucus production narrowing of the airways structural changes in the lungs (known as airway remodelling) Because eosinophilic asthma does not always respond well to standard asthma treatments like inhaled corticosteroids and bronchodilators, biologic therapies are often recommended. These are specialized medications that help control the disease by blocking the specific pathways that cause eosinophilic inflammation.1 What is Fasenra? Fasenra is a biologic therapy designed specifically for adults with eosinophilic asthma. It is used in addition to standard asthma treatments such as high-dose inhaled corticosteroids and long-acting beta- agonists, especially when these treatments alone are not sufficient to manage the condition.4 What is the active ingredient in Fasenra? The active substance in Fasenra is benralizumab, a type of medication called a monoclonal antibody. Monoclonal antibodies are laboratory-made proteins that can recognize and attach to specific targets in the body.4 How does Fasenra work? In eosinophilic asthma, eosinophils become overly active and build up in the lungs and blood. This build-up leads to inflammation, thereby triggering asthma attacks. The active ingredient in Fasenra – benralizumab – works by binding to a receptor on the surface of eosinophils called the interleukin-5 receptor. When Fasenra binds to this receptor, it signals the immune system to destroy the eosinophils in the blood and lungs. By reducing the number of eosinophils, Fasenra helps to lower inflammation in the airways. This results in fewer asthma flare-ups and improved symptom control.4 Who can take Fasenra?

2. Fasenra is prescribed for adults who have severe eosinophilic asthma. It is used when asthma is not well controlled with other standard treatments – such as high-dose inhaled corticosteroids and additional asthma medications.5 Fasenra is also approved for treating a condition called eosinophilic granulomatosis with polyangiitis (EGPA). EGPA causes inflammation of blood vessels and can affect various organs such as the skin, heart and kidneys.5 If you have severe asthma or EGPA, your doctor may prescribe Fasenra after evaluating whether it fits your specific needs. How is Fasenra administered? Fasenra is given as an injection just under the skin (subcutaneous injection). It comes in a pre-filled syringe or a pre-filled pen for ease of use. The injection can be given in the thigh or abdomen; healthcare providers may also inject it into the upper arm.5 Although administered by healthcare professionals, after proper training and based on the physician’s discretion, some patients or their caregivers may be able to administer the injection at home – especially if there is no history of serious allergic reactions.4 How long should treatment be continued? Treatment should continue as long as it benefits the patient. Your doctor will reassess your condition at least once a year to decide whether it is appropriate to keep using the medication.4 What are the possible side effects of Fasenra? Most people tolerate Fasenra well, but as with all medicines, side effects can occur. The most reported side effects include headache, fever, rash and sore throat (pharyngitis).5 Some patients may also experience5 • Allergic reactions (such as swelling or difficulty breathing) • Fainting, dizziness, feeling lightheaded If you experience any severe symptoms after an injection, seek medical help immediately. How to store and handle Fasenra appropriately? To ensure Fasenra stays safe and effective, it is important to store and handle it correctly5: • Keep it refrigerated between 2°C to 8°C. • Do not shake or freeze the syringe or pen. • Fasenra is meant for single use only – once used, it should be discarded safely. • Before injecting, let the pen or syringe sit at room temperature for about 30 minutes. Do not warm it up using heat sources like microwaves, hot water or direct sunlight. • Always check the expiry date on the label and carton. The medication should not be used after the last day of the month listed as ‘EXP’. How does Fasenra compare with other biologic treatments?

3. Several biologics are now available for treating severe asthma, including mepolizumab, reslizumab, dupilumab and omalizumab. Each of these targets different pathways in the immune system. What makes Fasenra unique is its ability to directly trigger the destruction of eosinophils. Fasenra does this through a mechanism called antibody-dependent cell-mediated cytotoxicity. This leads to a more complete depletion of eosinophils in the blood, which may help improve asthma control in certain patients.6 Your doctor will decide on the most suitable biologic based on factors like your eosinophil count, allergy profile and other health conditions.6 How to access Fasenra in India? Fasenra is available in India through a Named Patient Program (NPP) – a special access route for drugs not yet widely marketed in the country.7 What is an NPP? An NPP allows doctors to request an imported medication for a specific patient when local treatment options have been exhausted or are ineffective. Steps to Access Fasenra via NPP: 1.Consult your pulmonologist or allergy specialist. 2.Get your blood eosinophil count tested. 3.If eligible, your doctor will oFill out the necessary application forms. oSubmit them to the relevant health authorities or pharma distributor. 4.Once approved, the medicine will be imported and delivered to your hospital or clinic. NPP access may involve additional paperwork and cost considerations, so it is important to have a detailed discussion with your doctor or hospital pharmacy. Final Takeaway • Fasenra is a biologic therapy designed specifically for adults with eosinophilic asthma. • It is an add-on therapy to your standard asthma medications. • Pre-filled syringe or a pre-filled pen is intended for single use only – once used, it should be discarded safely. • In India, Fasenra can be accessed through a Named Patient Program. Frequently Asked Questions 1. Can I stop taking my inhaler once I start Fasenra? No. Fasenra is an add-on therapy, not a replacement for your usual asthma medications. You must continue using your inhaler unless your doctor advises otherwise.5 2. Is long-term use of Fasenra safe?

4. Fasenra is intended for long-term treatment. A decision to continue the therapy should be made at least annually based on disease severity, level of disease control and blood eosinophil counts.5 3. What if I miss a dose? If an injection is missed on the planned date, dosing should resume as soon as possible on the indicated regimen; a double dose must not be administered.5 4. Can I take Fasenra if I’m pregnant or breastfeeding? There is limited data on Fasenra use during pregnancy or breastfeeding. Always inform your doctor if you are pregnant or planning to become pregnant.5 Note: The information provided is for education purpose only and is subjected to prescribing information of the drug and the guidance of your treating physician. Always consult your health care provider before making any medical decision for starting your treatment. Disclaimer: Rx4U procures prescribed medicines directly from manufacturers or authorized distributors. It does not claim ownership of any trademarks and complies with the provisions of the Trademark Act, 1999, particularly Sections 30 and 30(1) concerning ‘Fair Use’. It solely facilitates access to new launches through named patient import. References: 1.Cushen B, Menzies-Gow A. Benralizumab: an updated treatment of eosinophilic asthma. Expert Rev RespirMed. 2020;14(5):435-444. 2.Schoettler N, Strek ME. Recent advances in severe asthma: from phenotypes to personalized medicine.Chest. 2020;157(3):516-528. doi:10.1016/j.chest.2019.10.009 3.Hussain M, Liu G. Eosinophilic asthma: pathophysiology and therapeutic horizons.Cells. 2024;13(5):384. doi:10.3390/cells13050384 4.Fasenra. European Medicines Agency. Updated February 13, 2025. Accessed June 26, 2025. https://www.ema.europa.eu/en/medicines/human/EPAR/fasenra 5.Fasenra. Product information. AstraZeneca AB. 6.Dragonieri S, Carpagnano GE. Biological therapy for severe asthma. Asthma Res Pract. 2021;7(1):12. 7.Patil S. Early access programs: Benefits, challenges, and key considerations for successful implementation.Perspect Clin Res. 2016;7(1):4-8. doi:10.4103/2229-3485.173779