In the MANDARA pivotal EGPA trial (52 weeks), FASENRA demonstrated noninferiority to mepolizumab for the primary endpoint of remission and the components of remission. 59% remission at Weeks 36 and 48 (n=41) with FASENRA and 57% with mepolizumab (n=40).1,2
See study design below.
Clinical data
(MANDARA study)
Safety data
(MANDARA study)
Resources
MANDARA (52 weeks) is a Phase 3, multicenter, double-blind, randomized, active-controlled, head-to-head noninferiority trial evaluating the efficacy and safety of FASENRA 30 mg SC compared to mepolizumab 300 mg SC every 4 weeks. A total of 140 patients aged 18 years and older with an EGPA diagnosis and a history of relapsing or refractory disease who were receiving standard care underwent randomization in a 1:1 ratio to receive FASENRA or mepolizumab.1-4
The primary endpoint was remission (BVAS=0 and OCS ≤4 mg per day) at Weeks 36 and 48. Secondary endpoints included total accrued duration of remission, remission within the first 24 weeks and maintenance of remission to Week 52, the time from randomization to first relapse, major relapse, the frequency of relapse during the double-blind period, and the average daily oral glucocorticoid dose during Weeks 48 through 52.1-3
BVAS, Birmingham Vasculitis Activity Score; EGPA, eosinophilic granulomatosis with polyangiitis; OCS, oral corticosteroid; SC, subcutaneous.
Known hypersensitivity to benralizumab or excipients.
Hypersensitivity Reactions
Hypersensitivity reactions (eg, anaphylaxis, angioedema, urticaria, rash) have occurred after administration of FASENRA. These reactions generally occur within hours of administration, but in some instances have a delayed onset (ie, days). Discontinue in the event of a hypersensitivity reaction.
Acute Asthma Symptoms or Deteriorating Disease
FASENRA should not be used to treat acute asthma symptoms, acute exacerbations, or acute bronchospasm.
Reduction of Corticosteroid Dosage
Do not discontinue systemic or inhaled corticosteroids abruptly upon initiation of therapy with FASENRA. Reductions in corticosteroid dose, if appropriate, should be gradual and performed under the direct supervision of a physician. Reduction in corticosteroid dose may be associated with systemic withdrawal symptoms and/or unmask conditions previously suppressed by systemic corticosteroid therapy.
Parasitic (Helminth) Infection
It is unknown if FASENRA will influence a patient's response against helminth infections. Treat patients with pre-existing helminth infections before initiating therapy with FASENRA. If patients become infected while receiving FASENRA and do not respond to anti-helminth treatment, discontinue FASENRA until infection resolves.
The most common adverse reactions (incidence ≥ 5%):
Injection site reactions (eg, pain, erythema, pruritus, papule) occurred at a rate of 2.2% in patients treated with FASENRA compared with 1.9% in patients treated with placebo in asthma exacerbation studies.
The data on pregnancy exposure from the clinical trials are insufficient to inform on drug-associated risk. Monoclonal antibodies such as benralizumab are transported across the placenta during the third trimester of pregnancy; therefore, potential effects on a fetus are likely to be greater during the third trimester of pregnancy.
FASENRA is indicated for:
Please read full Prescribing Information, including Patient Information.
1. FASENRA® (benralizumab) [package insert]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; September 2026. 2. Wechsler ME, Nair P, Terrier B, et al. Benralizumab versus mepolizumab for eosinophilic granulomatosis with polyangiitis. N Engl J Med. 2024;390(10):911-921. 3. Wechsler ME, Nair P, Terrier B, et al. Benralizumab versus mepolizumab for eosinophilic granulomatosis with polyangiitis. N Engl J Med. 2024;390(10)(suppl):1-46. 4. Merkel PA, Nair PK, Khalidi N, et al. Two-year efficacy and safety of anti-interleukin-5/receptor therapy for eosinophilic granulomatosis with polyangiitis. Ann Rheum Dis. 2025;84(11):1888-1899.