{"id":629783,"date":"2024-09-13T12:06:27","date_gmt":"2024-09-13T16:06:27","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=629783"},"modified":"2024-10-25T09:44:39","modified_gmt":"2024-10-25T13:44:39","slug":"fasenra-vs-nucala","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/fasenra-vs-nucala\/","title":{"rendered":"Fasenra vs. Nucala: Differences, similarities & side effects"},"content":{"rendered":"

Biologics are a burgeoning drug category being used, among other things, to reduce bronchial inflammation with asthma. We will be breaking down the differences between two major biologics for asthma: Fasenra (benralizumab) and Nucala (mepolizumab). They are both injectable <\/span>monoclonal antibodies<\/span><\/a> that lessen the effects of interleukin-5 (IL-5), a key messenger within our immune system. Choosing between <\/span>Fasenra<\/span><\/a> and <\/span>Nucala<\/span><\/a> to manage severe asthma requires complex decision-making and communication with your healthcare provider, but having an understanding of how the drugs work can help you understand why they may prescribe one over the other. <\/span><\/p>\n

Fasenra vs. Nucala: Key differences<\/span><\/h2>\n

Both drugs work by preventing IL-5 from doing its job, namely signaling immune cells called eosinophils, which are partially responsible for asthma and allergies. Fasenra is an antibody that targets the IL-5 receptor, and Nucala is an antibody that goes after IL-5 itself. The subtle mechanistic difference could explain some of the differences between the two.<\/span><\/p>\n

The Food and Drug Administration (FDA) has approved Fasenra for maintenance treatment of severe asthma. Nucala has a more robust array of indications and has been FDA approved to treat severe eosinophilic asthma, eosinophilic granulomatosis with polyangiitis (EGPA), hypereosinophilic conditions, and rhinosinusitis with nasal polyps. <\/span><\/p>\n

They are both given by subcutaneous injection under the skin, which can be given at home by most patients after they learn the proper technique. The intervals are a bit different though. Nucala requires administration every four weeks. Fasenra therapy starts with injections every four weeks, but after three doses, it can be changed to every eight weeks, making it a bit more convenient.<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

Compare Fasenra vs. Nucala key differences<\/span><\/h3>\n<\/th>\n<\/tr>\n<\/thead>\n

<\/td>\nFasenra<\/b><\/td>\nNucala<\/b><\/td>\n<\/tr>\n
Drug class<\/b><\/td>\nInterleukin-5 antagonist, monoclonal antibody<\/span><\/td>\nInterleukin-5 antagonist, monoclonal antibody<\/span><\/td>\n<\/tr>\n
Brand\/generic status<\/b><\/td>\nBrand<\/span><\/td>\nBrand<\/span><\/td>\n<\/tr>\n
What is the generic name?<\/b><\/p>\n

Or<\/b><\/p>\n

What is the brand name?<\/b><\/td>\n

Benralizumab<\/span><\/td>\nMepolizumab<\/span><\/td>\n<\/tr>\n
What form(s) does the drug come in?<\/b><\/td>\nSubcutaneous injection via auto-injector or prefilled syringe<\/span><\/td>\nSubcutaneous injection via auto-injector or prefilled syringe<\/span><\/td>\n<\/tr>\n
What is the standard dosage?<\/b><\/td>\n30 mg injected every 8 weeks in adults<\/span><\/td>\n100–300 mg injected every 4 weeks in adults<\/span><\/td>\n<\/tr>\n
How long is the typical treatment?<\/b><\/td>\nIndefinite if required<\/span><\/td>\nIndefinite if required<\/span><\/td>\n<\/tr>\n
Who typically uses the medication?<\/b><\/td>\n6 years and older<\/span><\/td>\n6 years and older, depending on diagnosis<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Fasenra vs. Nucala: Conditions treated<\/span><\/h2>\n

The biologics are the big guns when it comes to asthma treatment. They are not go-to drugs for mild to moderate cases of asthma; they <\/span>may not even work well in this setting<\/span><\/a> or be worth the danger of immune suppression. Selecting which asthma medication patients should use is complicated and typically requires a pulmonary or allergy and immunology specialist. <\/span><\/p>\n

Conventional asthma controllers, such as <\/span>inhaled corticosteroids<\/span><\/a>, <\/span>long-acting beta agonists<\/span><\/a>, and <\/span>leukotriene receptor antagonists<\/span><\/a>, are typically prescribed first. Biologics are then a potential add-on therapy if needed for frequent asthma exacerbations or persistent symptoms in the setting of <\/span>eosinophilic asthma<\/span><\/a>.<\/span><\/p>\n

A patient with asthma coupled with additional diagnoses like eczema, EGPA, and rhinosinusitis with nasal polyps, may be a better candidate for biologics like Fasenra and Nucala. Diagnostic studies like lung function testing and biomarkers like blood eosinophil counts are necessary to identify who might benefit from these drugs. Age can be an important determinant since adults seem to respond better than children. In addition, attempting to reduce or discontinue chronic steroids for asthma because of their long-term detriments, can be another compelling reason to consider biologics like Nucala and Fasenra for asthma.<\/span><\/p>\n

Fasenra and Nucala are both options for those with severe asthma and elevated eosinophil counts. Nucala has indications for additional eosinophil-mediated medical problems, too.<\/span><\/p>\n\n\n\n\n\n\n\n\n\n
\n

Compare Fasenra vs. Nucala conditions treated<\/span><\/h3>\n<\/th>\n<\/tr>\n<\/thead>\n

Condition<\/b><\/td>\nFasenra<\/b><\/td>\nNucala<\/b><\/td>\n<\/tr>\n
Severe eosinophilic asthma<\/span><\/td>\nYes<\/span><\/td>\nYes<\/span><\/td>\n<\/tr>\n
Eosinophilic granulomatosis with polyangiitis<\/span><\/td>\nNo<\/span><\/td>\nYes<\/span><\/td>\n<\/tr>\n
Hypereosinophilic syndrome<\/span><\/td>\nNo<\/span><\/td>\nYes<\/span><\/td>\n<\/tr>\n
Rhinosinusitis with nasal polyps<\/span><\/td>\nNo<\/span><\/td>\nYes<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Is Nucala better than Fasenra?<\/span><\/h2>\n

For the treatment of severe eosinophilic asthma, choosing between Nucala and Fasenra based on efficacy is a challenge. There are no direct head-to-head comparisons of the products. Moreover, there is no direct evidence of superiority between the three IL-5 antagonists (Fasenra, Nucala, and <\/span>Cinqair<\/span><\/a> [reslizumab]) and other biologics for asthma. Such biologic alternatives include <\/span>Xolair<\/span><\/a> (omalizumab), <\/span>Dupixent<\/span><\/a> (dupilumab), and <\/span>Tezspire<\/span><\/a> (tezepelumab).<\/span><\/p>\n

We can get an idea about efficacy expectations by looking at studies on individual drugs and making indirect comparisons. A <\/span>systematic review<\/span><\/a> published in 2020 did just that and included Fasenra and Nucala. Both drugs cut the rate of asthma exacerbations approximately in half and reduced the dependence on oral corticosteroids. Improvement in quality of life was not substantial enough to be considered statistically significant, though. Based on these findings, there’s no compelling reason to choose Fasenra over Nucala, and vice versa, based on effectiveness.<\/span><\/p>\n

Fasenra vs. Nucala: Insurance coverage and cost comparison<\/span><\/h2>\n

The reality is that deciding between Fasenra and Nucala may be in the hands of your health insurance. If your insurance’s <\/span>drug formulary<\/span><\/a> includes one and not the other or designates a more preferred status to one of the drugs, your choice may come down to finances. Your out-of-pocket <\/span>copay<\/span><\/a> could be much less if a medication is listed as preferred, an important matter when it comes to pricey brand-name products. For example, <\/span>Aetna’s Standard Control Plan categorizes Fasenra<\/span><\/a> and <\/span>Nucala as specialty preferred drugs<\/span><\/a>.<\/span><\/p>\n

Specialty drugs require special handling and need to be purchased from a specialty pharmacy, where pricing information is sometimes limited. The <\/span>manufacturer’s list price<\/span><\/a> for a single, 30 mg dose of Fasenra is $5,511, but patients don’t often pay the list price, which varies by pharmacy and insurance. The <\/span>list price of Nucala<\/span><\/a> is $3,689. Those are striking numbers, but <\/span>savings opportunities for Nucala<\/span><\/a> and <\/span>Fasenra<\/span><\/a> are available. Additionally, you may be able to show your <\/span>SingleCare discount card<\/span><\/a> to your pharmacist to make either biologic more affordable.<\/span><\/p>\n\n\n\n\n\n\n\n\n\n
\n

Compare Fasenra vs. Nucala cost & coverage<\/span><\/h3>\n<\/th>\n<\/tr>\n<\/thead>\n

<\/td>\nFasenra<\/b><\/td>\nNucala<\/b><\/td>\n<\/tr>\n
Typically covered by insurance?<\/b><\/td>\nYes but coverage varies<\/span><\/td>\nYes but coverage varies<\/span><\/td>\n<\/tr>\n
Typically covered by Medicare Part D?<\/b><\/td>\nYes but coverage varies<\/span><\/td>\nYes but coverage varies<\/span><\/td>\n<\/tr>\n
Quantity<\/b><\/td>\n1, 30 mg\/mL injection<\/span><\/td>\n1, 100 mg\/mL injection<\/span><\/td>\n<\/tr>\n
List price<\/b><\/td>\n$5,511<\/span><\/td>\n$3,689<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Fasenra vs. Nucala side effects<\/span><\/h2>\n

Side effects are similar between Fasenra and Nucala. Headache, back pain, and injection site reactions headline the list of common side effects from Nucala. Headache, fever, and sore throat are at the top for frequency on Fasenra’s side effect list. Although the following table lists a higher incidence of headache with Nucala, the rate of headache reported by those taking placebo (inactive pill) was much higher in the Nucala study than in the Fasenra study, suggesting that the difference might be based on study participants rather than the drugs.<\/span><\/p>\n

In terms of severe side effects that are less common, they both carry risks of severe hypersensitivity allergic reactions and opportunistic infections, such as parasitic infections. Nucala can increase one’s risk of a shingle outbreak.<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n
\n

Compare Fasenra vs. Nucala side effects<\/span><\/h3>\n<\/th>\n<\/tr>\n<\/thead>\n

<\/td>\nFasenra<\/b><\/td>\nNucala<\/b><\/td>\n<\/tr>\n
Side effect<\/b><\/td>\nApplicable?<\/b><\/td>\nFrequency<\/b><\/td>\nApplicable?<\/b><\/td>\nFrequency<\/b><\/td>\n<\/tr>\n
Headache<\/span><\/td>\nYes<\/span><\/td>\n8%<\/span><\/td>\nYes<\/span><\/td>\n19%<\/span><\/td>\n<\/tr>\n
Injection site reaction<\/span><\/td>\nYes<\/span><\/td>\n2%<\/span><\/td>\nYes<\/span><\/td>\n8%<\/span><\/td>\n<\/tr>\n
Back pain<\/span><\/td>\nNo<\/span><\/td>\n<\/td>\nYes<\/span><\/td>\n5%<\/span><\/td>\n<\/tr>\n
Sore throat<\/span><\/td>\nYes<\/span><\/td>\n5%<\/span><\/td>\nYes<\/span><\/td>\n3%<\/span><\/td>\n<\/tr>\n
Fever<\/span><\/td>\nYes<\/span><\/td>\n3%<\/span><\/td>\nYes<\/span><\/td>\n3%<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
Source: <\/span>Fasenra drug label<\/span><\/a> and <\/span>Nucala drug label<\/span><\/a><\/h5>\n

Fasenra and Nucala drug interactions<\/span><\/h2>\n

No drug interactions are posted on the labels for Fasenra or Nucala. While interactions may not be identified yet, caution is still needed when starting a new medicine. You should ask your healthcare provider and pharmacist to review your list of prescription drugs, over-the-counter pills, and supplements to look for drug-drug interactions. Even if they do not interact, additive side effects can be problematic. For instance, adding Fasenra or Nucala to a regimen that already includes an immunosuppressant would require particular caution regarding infection risk.<\/span><\/p>\n

Fasenra and Nucala Drug warnings<\/span><\/h2>\n

The FDA has not applied any <\/span>black box warnings<\/span><\/a> or <\/span>recalls<\/span><\/a> to Fasenra or Nucala. Nonetheless, there are some matters of concern. For one, the drugs can both trigger a dangerous allergic reaction or acute bronchospasm. Infection risk is also a worry, particularly parasitic infections. Herpes zoster, known more commonly as shingles, is enough of a concern with Nucala that the drug’s label suggests considering <\/span>shingles vaccination<\/span><\/a> prior to starting the medication.<\/span><\/p>\n

The safety of Fasenra and Nucala during pregnancy or while breastfeeding is unknown. At the same time, uncontrolled asthma is known to be a risk. Decisions about whether to use these monoclonal antibody therapies must take into account both benefits and risk, using shared decision-making between healthcare providers and patients.<\/span><\/p>\n

Fasenra vs. Nucala vs. Dupixent<\/span><\/h2>\n

If you are considering Fasenra and Nucala, then including <\/span>the biologic Dupixent<\/span><\/a> in the comparison makes sense. Dupixent is a monoclonal antibody injected every two to four weeks that blocks the IL-4 receptor, so its frequency and mechanism are a little different from the IL-5 antagonists. <\/span>Cost can be just as much of an issue with Dupixent<\/span><\/a>, retailing at about $5,221 but coming down to $3,606 for 2, 300 mg\/2 mL pens with a SingleCare <\/span>Dupixent coupon<\/span><\/a>.<\/span><\/p>\n

Like Fasenra and Nucala, Dupixet is FDA approved to treat asthma, including moderate to severe eosinophilic or corticosteroid-dependent asthma. Dupixent has other approved uses as well: atopic dermatitis, eosinophilic esophagitis, rhinosinusitis with nasal polyps, and prurigo nodularis. Only a healthcare provider familiar with your symptoms and health history can recommend the best medication for you.<\/span><\/p>\n

RELATED: <\/b>Nucala vs. Dupixent<\/b><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Biologics are a burgeoning drug category being used, among other things, to reduce bronchial inflammation with asthma. We will be breaking down the differences between two major biologics for asthma: Fasenra (benralizumab) and Nucala (mepolizumab). They are both injectable monoclonal antibodies that lessen the effects of interleukin-5 (IL-5), a key messenger within our immune system. […]<\/p>\n","protected":false},"author":149,"featured_media":629784,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8313],"tags":[10965],"coauthors":[20732],"class_list":["post-629783","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-vs-drug","tag-asthma","wpautop"],"acf":[],"yoast_head":"\nFasenra vs. Nucala: Differences, similarities & side effects<\/title>\n<meta name=\"description\" content=\"Fasenra and Nucala both treat severe eosinophilic asthma, but they work in different ways and have other differences to consider when determining which drug to take.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.singlecare.com\/blog\/fasenra-vs-nucala\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta 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