Benralizumab injections: Hi all, Hope... - Asthma Community ...

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Benralizumab injections

HoppyNurse profile image
15 Replies

Hi all,

Hope everyone is keeping well in the current climate. It’s 5.40am I’ve been up since 4am - good old predsomnia and being mid flare! Anyone here having Benralizumab injections for eosinophilic asthma and have still had flare ups? I had my first injection 3 weeks ago and was under the impression that my asthma symptoms would ease significantly after the first dose. I was admitted to hospital last Monday for another flare, discharged the next day as the team were concerned regarding COVID 19. I haven’t been right since then, still taking salbutamol 4-6 hourly 10 puffs and steroids reduced yesterday to 35mg - Initially my team asked me to drop back to 10mg after 7 days but I felt that this was not a great idea considering I was still symptomatic. I am borderline needing admission with sats of 93% and a peak flow at 30%, the nurse at my GP has been great phoning me regularly yesterday to see how I am. I guess the point of the post is does the Benralizumab take some time to have an effect or do most people have noticeably relief soon after the injection, as I’m currently feeling a bit disheartened as it’s not having the effect I was hoping on.

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HoppyNurse profile image
HoppyNurse
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15 Replies
Js706 profile image
Js706

Hi HoppyNurse,

Sorry to hear you’re still struggling. I can’t answer anything about the benralizumab but that really doesn’t sound borderline to me.

A peak flow of 30% puts you in the life threatening asthma category and sats of 92% would also do that.

I know that with COVID around it’s a worrying time for asthmatics but there’s no point staying home if you then get to the point that your asthma could kill you.

Please do not delay seeking help as your home treatment clearly is not working.

EmmaF91 profile image
EmmaF91Community Ambassador

Hi

I’m on benra, and had 4 admissions since being on it (2 infection caused and 2 allergic). It is not a cure all, yes I managed a long time without needing admission when I started it, but that was more luck and chance I think 😅.

I completely agree with Js706. It doesn’t sound like you are mod flare, it sounds like you need hosp ASAP. 30% PF is life threatening, and you’re only 1% off of the same for your sats.

Please go to hosp ASAP for treatment, what you’re doing at home obvs isn’t enough atm, and you’re at greater risk of dying from asthma at home atm, so the risk of catching covid, whilst a worry, needs to be put into perspective. As for a side room if you can as this is severe asthma and you don’t have any covid symptoms etc etc

Good luck and I hope the hosp can sort you out, without throwing you out too early

Ticaboorhino profile image
Ticaboorhino in reply to EmmaF91

Hi Emma 91. I needed your positivity this morning. I was on Mebo/Nucala for a year. Did help dramatically with the thick mucus plugs that were scary. Have Eosinophilic asthma. Fortunately oxygen hasn't been an issue. No hospital admissions. I do admit that when I hear some of your stories I shouldn't complain at all. My problem is that my chest tightens up and I feel like an elephant is sitting on my. I get instantly weak and feel like I am going to pass out. The oxygen doesn't profuse. If I concentrate on taking deep slow breaths I do better, then do the neb thing. Nucala made me tired and weak. Just started Fasenra. Not as weak with it. Having chest pressure issues due to spring trees. I appreciate the posts. It opens up more understanding of dealing with asthma. I am in the USA. We are pretty much quarantined from covid19. Don't have to look far to realize how lucky one is.

HoppyNurse profile image
HoppyNurse

Hi, just to update you, after numerous conversations with GP’s and Nurses. It was decided that i needed an ambulance. So after a blue light ride, 6 b2b nebs and magnesium I’m am feeling much better. Still needing a nebulisers after 2 hours but better than I was this morning and peak flow has improved - it’s still less than 50% but it’s better than it was! Just waiting for a plan now .....

HoppyNurse profile image
HoppyNurse in reply to HoppyNurse

And they are discharging me already! With no plan.

EmmaF91 profile image
EmmaF91Community Ambassador in reply to HoppyNurse

Ugh no. That’s crap. Call your team and ask for advice! ESP as you were needing 2hrly nebs! (Or your spec hosp if it’s a different hosp) according to guidelines you’re still having a severe asthma attack

HoppyNurse profile image
HoppyNurse in reply to EmmaF91

They have given me a prescription for neb ampules - I don’t have a nebuliser at home.

EmmaF91 profile image
EmmaF91Community Ambassador in reply to HoppyNurse

Please call your team and tell them this. There’s a shortage of nebulisers to buy atm, igniting the fact you’d have to wait for it to be delivered...

HoppyNurse profile image
HoppyNurse in reply to EmmaF91

I’ve spoken to my team, not the most helpful but basically said if I needed a neb I had to go back in, but didn’t mention threshold on how much inhaler I could use - I’m currently 2 hourly - the same as I was in the hospital and they will call tomorrow with a plan re steroids I feel like they should be adding another med in but they seem very reluctant. My lovely GP is going to ring to make sure I’m ok in an hour or so - after a long conversation with her. The dr documented that my sats were 98 and my resps were 18! They are more like 36, and my sats are currently 94! My peak flow was 220 on discharge- 480 is my best. It’s all a bit of a mess and headache - I’m so tired and exhausted from everything breathing itself is tiring I’ve not even got the energy to eat!

EmmaF91 profile image
EmmaF91Community Ambassador in reply to HoppyNurse

Please just readmit yourself to a&e. None of this is sounding good. And salb should be no more than 4hrly unless agreed by YOUR con (not a&e not someone who’s only met you once etc)

twinkly29 profile image
twinkly29 in reply to HoppyNurse

Do your GP surgery have one you can borrow?

EmmaF91 profile image
EmmaF91Community Ambassador in reply to HoppyNurse

Glad you went and got more help and that you’re starting to feel better now. Hope they get a plan in place for you quickly and that you start maintaining the improvement without the need of nebs soon!

Hamscoul profile image
Hamscoul

I have had my 2nd injection but I wanted to tell you I am enrolled in a study and its looking at this very thing. Why do flare ups still happen when the eosinophils are destroyed by the vaccine. I also asked if my meds would be reviewed with a view of reducing some of them. I was advised, as I was in 2012 no changes until attack free for a year.

My impression was the respiratory team did expect exacerbations to occur but less frequently and less severe.

I have had a very good response and I am sure you will to once things settle down. I really hope things get better for you and this flare up starts to settle.

HoppyNurse profile image
HoppyNurse

An update, I have managed to keep myself at home and actually am doing pretty well compared to the beginning of the week - it just goes to show how the stress of a situation can make things worse! My lovely GP has been phoning me twice a day to make sure I’m ok. The specialist team got back in contact and requested to see me today as an urgent appointment, I’ve had the full works today - lung function, bloods, respiratory virus screening and FeNo. I don’t know the results of the lung function- these were not shared with me today, but my FeNo is at the lowest it’s been in 6 months! So the Benralizumab appears to be doing its job, the impression from the consultant today is that I’ve likely got a virus that is causing some irritation to my lungs - possibly the lingering effect of influenza b that I had a few weeks ago! So the plan moving on is to wean my steroids and salbutamol use, get my second Benralizumab next week and keep fingers crossed that all goes well!

Ted201 profile image
Ted201

Hi HoppyNurse - Glad to hear you are feeling better! I'm 61 year old male with life long mild asthma that has gotten bad 10 years ago and quite uncontrolled over the last 2 years.

Regarding Benralizumab, I took my first injection 5 weeks ago (in doctor's office) and the second one a week ago (self injector pen at home - since didn't want to go out of house due to Covid- very very easy to do!). I wish I could say the benra is helping, but I can't definitively yet.

Concurrently I'm trying to ween off of prednisone. I've been on 2 months this go-around starting at 60mg and got it down to 2.5 mg currently. I thought maybe the Benralizumab was helping me get off the steroids, but in the last 2 days, for no reason I can identify, I feel tight and need the albuterol every 4-6 hrs. This is the second time this happened recently, where I got down to 2.5 mg prednisone only to flare. The last time resulted in urgent visit to pulmonologist and upping of the prednisone to 60mg plus medrol Depo shot and then titrating down over a month. If I don't feel better in the next day or so, I may just go back up to 10mg prednisone and see if that will keep me comfortable. I really don't want to yo-yo back to high dose prednisone!

Stay well everyone.

Thanks for listening to me. This was my first post. I find this forum Very Helpful.

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