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Anti-asthmatic agents

Third biological treatment for severe asthma approved by NICE

An injectable drug for patients who struggle to control their asthma with inhalers has been approved by the National Institute for Health and Care Excellence (NICE).

Benralizumab (Fasenra; AstraZeneca) — the third biological treatment for severe eosinophilic asthma to be approved for NHS use by NICE — works by targeting and depleting the immune cells in the blood that cause the condition.

The recommendation from NICE, published on 4 January 2019, means that people who are eligible for the other two approved treatments, mepolizumab and reslizumab, can now be offered benralizumab. If all three treatments are equally suitable for a patient, NICE recommends that prescribers should choose the cheapest option first.

Benralizumab may have a more convenient dosing schedule than the other two drugs, NICE said in a statement, as it is given as an injection every four weeks for the first three doses, and then every eight weeks thereafter. In contrast, mepolizumab, which is also injected, and resliszumab, an intravenous infusion, are both required to be given every four weeks throughout the treatment period.

Meindert Boysen, director of NICE’s Centre for Health Technology Evaluation, said: “People with severe eosinophilic asthma that is inadequately controlled often have a severely impaired quality of life.

“By keeping their asthma under better control, biological treatments have transformed the lives of some of these sufferers.

“This recommendation of a further biological option demonstrates how a competitive pharmaceuticals market combined with NICE’s appraisal process provides the NHS and patients with value for money and choice.”

Subject to appeals against its final appraisal document, NICE will publish final guidance in February 2019 and the NHS will need to make the drug available in England within three months of that date.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20205947

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