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Fasenra receives FDA approval for severe eosinophilic asthma

Monday, November 20, 2017

AstraZeneca and its global biologics research and development arm, MedImmune, announced that the FDA has approved FASENRA (benralizumab) for the add-on maintenance treatment of patients with severe asthma aged 12 years and older, and with an eosinophilic phenotype. FASENRA is not approved for the treatment of other eosinophilic conditions or relief of acute bronchospasm or status asthmaticus.

Pascal Soriot, Chief Executive Officer of AstraZeneca, said: “We’re excited to offer FASENRA as a new precision biologic to help improve the lives of severe asthma patients whose disease is driven by eosinophilic inflammation. This is the first approval from our respiratory biologics portfolio and the latest in a series of significant milestones for our company as we deliver on our pipeline-driven transformation.”

The FDA approval is based on results from the WINDWARD program, including the pivotal Phase III exacerbation trials, SIROCCO and CALIMA, and the phase III oral corticosteroid (OCS)-sparing trial, ZONDA. Results for the eight-week benralizumab dosing regimen from these trials showed:

  • Up to 51% reduction in the annual asthma exacerbation rate (AAER) versus placebo
  • Significant improvement in lung function as measured by forced expiratory volume in one second (FEV1) of up to 159 mL versus placebo. Differences were seen as early as 4 weeks after the first dose, providing an early indication of effectiveness
  • 75% median reduction in daily OCS use and discontinuation of OCS use in 52% of eligible patients
  • An overall adverse event profile similar to that of placebo. Adverse events with an incidence greater than or equal to 3% were headache, pyrexia, pharyngitis and hypersensitivity reactions

Eugene R. Bleecker, M.D., Professor and Co-Director, Genetics, Genomics and Precision Medicine, University of Arizona Health Sciences, and lead investigator of the pivotal phase III SIROCCO study, said: “This is an important day for severe, eosinophilic asthma patients who have had limited treatment options for far too long, with many relying on oral steroids to manage their symptoms. FASENRA has a strong clinical profile which includes the ability to show lung function improvement after the first dose, the potential to reduce—or even stop—oral steroid use, and the convenience of eight-week dosing. FASENRA also treats a distinct patient phenotype, helping physicians select the right patient in clinical practice with more confidence.”

FASENRA is the only respiratory biologic that provides direct, rapid and near-complete depletion of eosinophils within 24 hours, as observed in a phase II study. Eosinophils are a type of white blood cell that are a normal part of the body’s immune system. Elevated levels of eosinophils, seen in about half of severe asthma patients, impact airway inflammation and airway hyper-responsiveness, resulting in increased asthma severity and symptoms, decreased lung function and increased risk of exacerbations.

FASENRA binds directly to the IL-5α receptor on an eosinophil and uniquely attracts natural killer cells to induce apoptosis (programmed cell death). FASENRA will be available as a subcutaneous injection via a prefilled syringe administered once every four weeks for the first three doses, and then once every eight weeks thereafter.

Karen Kempley, severe, eosinophilic asthma patient, said: “Most people don’t appreciate the simple act of breathing until they can’t do it. As someone with severe asthma, I know how devastating it is to not have control over your asthma and to live with the fear of not knowing when your next asthma attack might happen. When you can’t breathe, you can’t do the things you want or need to do—like go to work or be with your family—and that impacts every aspect of your life.”

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