Drug1st-line biologic line

Benralizumab

Anti–IL-5Rα monoclonal antibody (ADCC-mediated eosinophil depletion)

Response rate
Near-complete eosinophil depletion
Onset
4 weeks
Route
SC 30mg every 4–8 weeks
Line
1st-line biologic
IgM effect
Reduces polyp score
Evidence level
green

Evidence summary

Binds IL-5Rα and induces antibody-dependent cellular cytotoxicity (ADCC), depleting eosinophils and basophils. OSTRO trial showed significant NPS and congestion improvement. FDA-approved 2024 for CRSwNP. Unique mechanism achieving near-complete tissue eosinophil depletion.

Molecular targets

MoleculeRoleExpressionEvidence
IL-5Eosinophil survival factorElevatedestablished
EosinophilsEffector granulocytesMassively infiltrated in tissueestablished

Sources (2)

T4Bachert C et al. (2024) Efficacy and safety of benralizumab in CRSwNP (OSTRO): randomised, placebo-controlled, phase 3 trialDOI
T5Fokkens WJ et al. (2020) EPOS/EUFOREA 2020 treatment algorithm for CRSwNPDOI