Cinqair is a brand-name prescription medication. It’s used to treat severe eosinophilic asthma in adults. With this type of severe asthma, you have high levels of eosinophils (a kind of white blood cell). You’ll take Cinqair in addition to your other asthma drugs. Cinqair isn’t used to treat asthma flare-ups.
Cinqair contains reslizumab, which is a type of drug called a biologic. Biologics are created from cells and not from chemicals.
Cinqair is part of a class of drugs called interleukin-5 antagonist monoclonal antibodies (IgG4 kappa). A drug class is a group of medications that work in a similar way.
A healthcare provider will give you Cinqair as an intravenous (IV) infusion in your doctor’s office or a clinic. This is an injection into your vein that’s slowly dripped in over time. Cinqair infusions usually take 20 to 50 minutes.
Effectiveness
Cinqair has been found to be effective for the treatment of severe eosinophilic asthma.
In two clinical studies, 62% and 75% of people who received Cinqair for severe eosinophilic asthma didn’t have an asthma flare-up. But only 46% and 55% of people who took a placebo (no treatment) didn’t have an asthma flare-up. All the people were treated with Cinqair or placebo for 52 weeks. Also, most of the people were taking inhaled corticosteroids and beta-agonists during the study.
Cinqair is available only as a brand-name medication. It contains the active drug reslizumab.
Cinqair isn’t currently available in a biosimilar form.
A biosimilar is a medication that’s similar to a brand-name drug. A generic medication, on the other hand, is an exact copy of a brand-name drug. Biosimilars are based on biologic medications, which are created from parts of living organisms. Generics are based on regular medications made from chemicals.
Biosimilars and generics are both as safe and effective as the brand-name drug they’re made to copy. Also, they tend to cost less than brand-name medications.
As with all medications, the cost of Cinqair can vary. A healthcare provider will give you the drug as an intravenous (IV) infusion at your doctor’s office or a clinic. The cost you pay for your infusion will depend on your insurance plan and where you receive your treatment. Cinqair isn’t available for you to purchase at a local pharmacy.
Financial and insurance assistance
If you need financial support to pay for Cinqair, or if you need assistance understanding your insurance coverage, help is available.
Teva Respiratory, LLC, the manufacturer of Cinqair, offers Teva Support Solutions. For more information and to find out if you’re eligible for support, call 844-838-2211 or visit the program website.
Cinqair can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while receiving Cinqair. These lists don’t include all possible side effects.
For more information on the possible side effects of Cinqair, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.
More common side effects
The most common side effect of Cinqair is oropharyngeal pain. This is pain in the part of your throat that’s behind your mouth. In clinical studies, 2.6% of people who took Cinqair had oropharyngeal pain. This was compared to 2.2% of people who took a placebo (no treatment).
Oropharyngeal pain may go away within a few days or a couple of weeks. If the pain is severe or doesn’t go away, talk with your doctor or pharmacist. They can suggest treatments to help you feel better.
Serious side effects
Serious side effects from Cinqair aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.
Serious side effects and their symptoms can include the following:
- Anaphylaxis* (a type of severe allergic reaction). Symptoms can include:
- trouble breathing, including coughing and wheezing
- trouble swallowing
- swelling in your face, mouth, or throat
- slow pulse
- anaphylactic shock (sudden drop in blood pressure and trouble breathing)
- rash
- itchy skin
- slurred speech
- abdominal (belly) pain
- nausea
- confusion
- anxiety
- Cancer. Symptoms can include:
* Cinqair has a
Side effect details
You may wonder how often certain side effects occur with this drug. Here’s some detail on a few of the side effects this drug may cause.
Allergic reaction
As with most drugs, some people can have an allergic reaction after receiving Cinqair. Symptoms of a mild allergic reaction can include:
It’s not known how many people developed a mild allergic reaction after they received Cinqair.
A more severe allergic reaction is rare but possible. It’s called anaphylaxis (see below).
Anaphylaxis
While receiving Cinqair, some people may develop a very rare allergic reaction called anaphylaxis. This reaction is severe and can be life-threatening. In clinical studies, 0.3% of people who received Cinqair developed anaphylaxis.
Your immune system helps protect your body against substances that may cause disease. But sometimes your body gets confused and fights substances that don’t cause disease. For some people, their immune system attacks ingredients in Cinqair. This can lead to anaphylaxis.
Symptoms of anaphylaxis can include:
- swelling under your skin, typically in your eyelids, lips, hands, or feet
- swelling of your tongue, mouth, or throat
- trouble breathing
Anaphylaxis can happen right after your second dose of Cinqair, so it’s important that the reaction is controlled at once.
This is why your healthcare provider will monitor you for several hours after you receive Cinqair. If you develop symptoms of anaphylaxis, your healthcare provider will treat you right away. They’ll also let your doctor know.
If your doctor wants you to stop using Cinqair, they may recommend a different medication.
Anaphylactic reactions can sometimes cause biphasic anaphylaxis. This is a second attack of anaphylaxis. Biphasic anaphylaxis can occur hours to several days after the first attack. If you have an anaphylactic reaction, your healthcare provider may want to monitor you further. They’ll want to ensure that you don’t develop biphasic anaphylaxis.
Symptoms of biphasic anaphylaxis can include:
- skin that’s itchy, red, or has hives (itchy welts)
- swollen face and tongue
- trouble breathing
- abdominal (belly) pain
- vomiting
- diarrhea
- low blood pressure
- loss of consciousness (fainting)
- anaphylactic shock (sudden drop in blood pressure and trouble breathing)
If you’re not at a healthcare facility and you think you’re having an anaphylactic or biphasic reaction to Cinqair, call 911 right away. After the reaction has been treated, let your doctor know. They may recommend a different asthma drug.
Cancer
Certain medications may cause your cells to keep growing in size or number and become cancerous. Sometimes these cancerous cells move to tissues in different parts of your body. These masses of tissues are called tumors.
In clinical studies, 0.6% of people who received Cinqair developed tumors that formed in different parts of the body. Most of the people were diagnosed with tumors within six months of their first dose of Cinqair. This was compared to 0.3% of people who took a placebo (no treatment).
If you notice any symptoms of tumors that don’t go away, tell your doctor. (See the “Serious side effects” section above for a list of symptoms.) You may need tests to help your doctor find out more about the tumors. Your doctor may also recommend a different asthma medication.
The Cinqair dosage your doctor prescribes will depend on your weight.
The following information describes dosages that are commonly used or recommended. However, your healthcare provider may give you a different one if directed by your doctor to do so. Your doctor will determine the best dosage to suit your needs.
Drug forms and strengths
Cinqair comes in a 10-mL vial. Each vial contains 100 mg of reslizumab. Your healthcare provider will give you this solution as an intravenous (IV) infusion. This is an injection into your vein that’s slowly dripped in over time. Cinqair infusions usually take 20 to 50 minutes.
Dosage for asthma
Cinqair is typically prescribed in dosages of 3 mg/kg, once every four weeks.
The amount of Cinqair that you receive will depend on how much you weigh. For example, a 150-lb. man weighs about 68 kg. If his doctor prescribes 3 mg/kg of Cinqair once every four weeks, the dose of Cinqair will be 204 mg per infusion (68 x 3 = 204).
What if I miss a dose?
If you miss an appointment to receive Cinqair, call your healthcare provider as soon as possible. They can schedule a new appointment and adjust the timing of other visits if needed.
It’s a smart idea to write your treatment schedule on a calendar. You can also set a reminder on your phone so that you don’t miss an appointment.
Will I need to use this drug long term?
Cinqair is meant to be used as a long-term treatment for severe eosinophilic asthma. If you and your doctor determine that Cinqair is safe and effective for you, you’ll likely use it for a long time.
The Food and Drug Administration (FDA) approves prescription drugs such as Cinqair to treat certain conditions. Cinqair is approved to treat severe eosinophilic asthma in adults. The drug isn’t approved to treat other types of asthma. Also, Cinqair isn’t approved to treat asthma flare-ups.
You’ll take Cinqair in addition to your current asthma treatment.
In a clinical study, Cinqair was given to 245 people with severe eosinophilic asthma for 52 weeks. In this group, 62% of people didn’t have an asthma flare-up during that time. This was compared to 46% of people who received a placebo (no treatment). Of those who did have an asthma flare-up:
- People who received Cinqair had a 50% lower rate of flare-ups in one year than people who received a placebo.
- People who received Cinqair had a 55% lower rate of flare-ups that required the use of corticosteroids than people who received a placebo.
- People who received Cinqair had a 34% lower rate of flare-ups that led to a hospital stay than people who received a placebo.
In another clinical study, Cinqair was given to 232 people with severe eosinophilic asthma for 52 weeks. In this group, 75% of people didn’t have an asthma flare-up during that time. This was compared to 55% of people who received a placebo (no treatment). Of those who did have an asthma flare-up:
- People who received Cinqair had a 59% lower rate of flare-ups than people who received a placebo.
- People who received Cinqair had a 61% lower rate of flare-ups that required corticosteroids than people who received a placebo.
- People who received Cinqair had a 31% lower rate of flare-ups that led to a hospital stay than people who received a placebo.
You’re meant to use Cinqair along with your current asthma medications. Examples of drugs that may be used with Cinqair to treat severe eosinophilic asthma include:
- Inhaled and oral corticosteroids. The most commonly used for severe asthma include:
- beclomethasone dipropionate (Qvar Redihaler)
- budesonide (Pulmicort Flexhaler)
- ciclesonide (Alvesco)
- fluticasone propionate (ArmonAir RespiClick, Arnuity Ellipta, Flovent Diskus, Flovent HFA)
- mometasone furoate (Asmanex HFA, Asmanex Twisthaler)
- prednisone (Rayos)
- Beta-adrenergic bronchodilators. The most commonly used for severe asthma include:
- salmeterol (Serevent)
- formoterol (Foradil)
- albuterol (ProAir HFA, ProAir RespiClick, Proventil HFA, Ventolin HFA)
- levalbuterol (Xopenex, Xopenex HFA)
- Leukotriene pathway modifiers. The most commonly used for severe asthma include:
- montelukast (Singulair)
- zafirlukast (Accolate)
- zileuton (Zyflo)
- Muscarinic blockers, a type of anticholinergic. The most commonly used for severe asthma include:
- tiotropium bromide (Spiriva Respimat)
- ipratropium
- Theophylline
Many of these drugs also come as combination products. For example, Symbicort (budesonide and formoterol) and Advair Diskus (fluticasone and salmeterol).
Another type of medication that you’ll need to keep using with Cinqair is a rescue inhaler. Although Cinqair works to help prevent asthma flare-ups, you may still have an asthma attack. When this happens, you’ll need to use a rescue inhaler to control your asthma right away. So be sure to carry your rescue inhaler with you at all times.
If you’re using Cinqair, don’t stop taking your other asthma medications unless your doctor tells you. And if you have questions about the number of drugs you take, ask your doctor.
Other drugs are available that can treat severe eosinophilic asthma. Some may be better suited for you than others. If you’re interested in finding an alternative to Cinqair, talk with your doctor. They can tell you about other medications that may work well for you.
Examples of other drugs that may be used to treat severe eosinophilic asthma include:
- mepolizumab (Nucala)
- benralizumab (Fasenra)
- omalizumab (Xolair)
- dupilumab (Dupixent)
You may wonder how Cinqair compares to other medications that are prescribed for similar uses. Here we look at how Cinqair and Nucala are alike and different.
Uses
The Food and Drug Administration (FDA) has approved both Cinqair and Nucala to treat severe eosinophilic asthma in adults. Nucala is also approved to treat severe eosinophilic asthma in children ages 12 to 18 years. Both medications are used along with other asthma drugs you’re taking.
In addition, Nucala is approved to treat a rare disease called eosinophilic granulomatosis with polyangiitis (EGPA). The disease is also known as Churg-Strauss syndrome, and it causes your blood vessels to become inflamed (swollen).
Both Cinqair and Nucala belong to a class of drugs called interleukin-5 antagonist monoclonal antibodies. A drug class is a group of medications that work in a similar way.
Drug forms and administration
Cinqair contains the active drug reslizumab. Nucala contains the active drug mepolizumab.
Cinqair comes in vials. Your healthcare provider will give you the solution as an injection into your vein (intravenous infusion). Cinqair infusions usually take 20 to 50 minutes.
Nucala comes in three different forms:
- A single-dose vial of powder. Your healthcare provider will mix the powder with sterile water. Then they’ll give you the solution as an injection under your skin (subcutaneous injection).
- A single-dose prefilled autoinjector pen. Your healthcare provider will first teach you how to use the pen. Then you can give yourself injections under your skin.
- A single-dose prefilled syringe. Your healthcare provider will first teach you how to use the syringe. Then you can give yourself injections under your skin.
Cinqair is typically prescribed in dosages of 3 mg/kg, once every four weeks. The amount of the drug that you receive will depend on how much you weigh.
The recommended dosage of Nucala for asthma is 100 mg, once every four weeks.
Side effects and risks
Cinqair and Nucala both belong to the same class of drugs, so they work in the same way. The two medications can cause very different or very similar side effects. Below are examples of these side effects.
More common side effects
These lists contain examples of more common side effects that can occur with Cinqair or with Nucala.
- Can occur with Cinqair:
- oropharyngeal pain (pain in the part of your throat that’s behind your mouth)
- Can occur with Nucala:
Serious side effects
These lists contain examples of serious side effects that can occur with Cinqair, with Nucala, or with both drugs (when given individually).
- Can occur with Cinqair:
- Can occur with Nucala:
- herpes zoster infection (shingles)
- Can occur with both Cinqair and Nucala:
- severe reactions, including anaphylaxis*
* Cinqair has a
Effectiveness
Cinqair and Nucala are both used to treat severe eosinophilic asthma.
These drugs haven’t been directly compared in clinical studies, but a
Costs
Cinqair and Nucala are both brand-name drugs. There are currently no biosimilar forms of either drug.
A biosimilar is a medication that’s similar to a brand-name drug. A generic medication, on the other hand, is an exact copy of a brand-name drug. Biosimilars are based on biologic medications, which are created from parts of living organisms. Generics are based on regular medications made from chemicals. Biosimilars and generics are both as safe and effective as the brand-name drug they’re trying to copy. Also, they tend to cost less than brand-name medications.
The actual price you’ll pay for either drug depends on your insurance plan and your location.
In addition to Nucala (above), Fasenra is another medication that has a use similar to that of Cinqair. Here we look at how Cinqair and Fasenra are alike and different.
Uses
The Food and Drug Administration (FDA) has approved both Cinqair and Fasenra to treat severe eosinophilic asthma in adults. Fasenra is also approved to treat severe eosinophilic asthma in children ages 12 to 18 years. Both drugs are used along with other asthma drugs you’re taking.
Both Cinqair and Fasenra belong to a class of drugs called interleukin-5 antagonist monoclonal antibodies. A drug class is a group of medications that work in a similar way.
Drug forms and administration
Cinqair contains the active drug reslizumab. Fasenra contains the active drug benralizumab.
Cinqair comes in a vial. Your healthcare provider will give you the solution as an injection into your vein (intravenous infusion). Cinqair infusions usually take 20 to 50 minutes.
Fasenra comes in a prefilled syringe. A healthcare provider will give you the drug as injection under your skin (subcutaneous injection).
Cinqair is typically prescribed in dosages of 3 mg/kg, once every four weeks. The amount of the drug that you receive will depend on how much you weigh.
For your first three doses of Fasenra, you’ll receive 30 mg once every four weeks. After that, you’ll receive 30 mg of Fasenra once every eight weeks.
Side effects and risks
Cinqair and Fasenra both belong to the same class of drugs, so they work in the same way. The two medications can cause very different or very similar side effects. Below are examples of these side effects.
More common side effects
These lists contain examples of more common side effects that can occur with Cinqair or with Fasenra.
- Can occur with Cinqair:
- oropharyngeal pain (pain in the part of your throat that’s behind your mouth)
- Can occur with Fasenra:
- headache
- sore throat
Serious side effects
These lists contain examples of serious side effects that can occur with Cinqair, with Fasenra, or with both drugs (when given individually).
- Can occur with Cinqair:
- Can occur with Fasenra:
- few unique common side effects
- Can occur with both Cinqair and Fasenra:
- severe reactions, including anaphylaxis*
* Cinqair has a
Effectiveness
Cinqair and Fasenra are both used to treat severe eosinophilic asthma.
These drugs haven’t been directly compared in clinical studies. But a review of studies found Cinqair to be more effective at preventing asthma flare-ups than Fasenra.
Costs
Cinqair and Fasenra are both brand-name drugs. There are currently no biosimilar forms of either drug.
A biosimilar is a medication that’s similar to a brand-name drug. A generic medication, on the other hand, is an exact copy of a brand-name drug. Biosimilars are based on biologic medications, which are created from parts of living organisms. Generics are based on regular medications made from chemicals. Biosimilars and generics are both as safe and effective as the brand-name drug they’re trying to copy. Also, they tend to cost less than brand-name medications.
The actual price you’ll pay for either drug will depend on your insurance plan and your location.
There aren’t any known interactions between Cinqair and alcohol at this time. But some people with asthma can develop flare-ups while drinking alcohol or after they’ve had alcohol. Wine, cider, and beer are more likely to cause these flare-ups than other alcoholic beverages.
If you have an asthma flare-up while drinking alcohol, stop drinking the alcohol right away. Let your doctor know about the flare-up during your next visit.
Also, talk with your doctor about how much and what type of alcohol you drink. They can tell you how much is safe for you to drink during your treatment.
There aren’t any known interactions between Cinqair and other medications, herbs, supplements, or foods. But some of these may increase your chance of having an asthma flare-up. For example, some food or drug allergies can cause asthma flare-ups.
If you have any food or drug allergies, tell your doctor. Also mention any drugs, herbs, or supplements that you take. Your doctor may recommend adjustments to your diet, medication, or lifestyle if needed.
A healthcare provider will give you Cinqair as an intravenous (IV) infusion in your doctor’s office or a clinic. This is an injection into your vein that’s slowly dripped in over time.
First, your healthcare provider will put a needle into one of your veins. Then they’ll connect a bag that contains Cinqair to the needle. The drug will flow from the bag to your body. This will take about 20 to 50 minutes.
After you’ve received your dose, your healthcare provider may monitor you to see if you develop anaphylaxis.* This is a type of severe allergic reaction. (For possible symptoms, see the “Cinqair side effects” section above). Anaphylaxis may happen after any dose of Cinqair. So your healthcare provider may monitor you even if you’ve received Cinqair before.
* Cinqair has a
When to get Cinqair
Cinqair is usually given once every four weeks. You and your doctor can discuss the best time of day for you to have your infusion.
It’s a smart idea to write your treatment schedule on a calendar. You can also set a reminder on your phone so that you don’t miss an appointment.
Cinqair contains the drug reslizumab, which belongs to a drug class called interleukin-5 antagonist monoclonal antibodies.
Cinqair is approved to treat eosinophilic asthma. To learn how Cinqair works to treat this condition, see this article.
Not enough clinical studies have been done in humans to prove whether Cinqair is safe to use during pregnancy. But it’s known that Cinqair travels through the placenta and reaches the baby. The placenta is an organ that grows in your womb while you’re pregnant.
Studies in animals suggest that no harmful effects will happen to the baby. But animal studies don’t always reflect what happens in humans.
If you’re taking Cinqair and become pregnant or want to become pregnant, talk with your doctor. They can help you decide whether Cinqair or another asthma medication is best for you.
There aren’t clinical studies in humans that prove whether it’s safe to breastfeed while taking Cinqair. But human studies suggest that proteins similar to those in Cinqair are present in human breast milk. Also, in animal studies, Cinqair was found in the breast milk of lactating animals. So it’s expected that Cinqair may be found in human breast milk, too. It’s not known how this would affect the child.
If you want to breastfeed while receiving Cinqair, tell your doctor. They can discuss the pros and cons with you.
Here are answers to some frequently asked questions about Cinqair.
Is Cinqair a biologic drug?
Yes. Cinqair is a type of drug called a biologic, which is created from living organisms. Regular medications, on the other hand, are created from chemicals.
Cinqair is also a monoclonal antibody. This is a type of biologic that interacts with your immune system. (Your immune system is what helps protect your body from disease.) Monoclonal antibodies like Cinqair attach to proteins in your immune system. When Cinqair attaches to these proteins, it stops them from causing inflammation (swelling) and other asthma symptoms.
Why doesn’t Cinqair come as an inhaler or a pill?
Your body can’t process Cinqair in inhaler or pill form, so the drug wouldn’t be able to help treat asthma.
Cinqair is a type of biologic drug known as a monoclonal antibody. (For more about biologics, see “Is Cinqair a biologic drug?” above.) Monoclonal antibodies are large proteins. If you take these drugs as pills, they would go directly to your stomach and intestines. There, acids and other small proteins would break down the monoclonal antibodies. Because the monoclonal antibodies are broken down into smaller pieces, they are no longer effective for treating asthma. So in pill form, this type of drug wouldn’t work well.
You can’t inhale most monoclonal antibodies either. If you did, proteins in your lungs would break down the inhaled drug right away. Very little of the medication would make it to your blood and cells. This would reduce how well the drug works in your body.
The best way for you to take monoclonal antibodies, including Cinqair, is through an intravenous (IV) infusion. (This is an injection into your vein that’s slowly dripped in over time.) In this form, the medication goes directly into your blood. No acids or proteins will break the drug down for at least a couple of weeks. So the medication can travel through your blood and work in the parts of your body that need it.
Why can’t I get Cinqair from a pharmacy?
The only way to get Cinqair is through your doctor. A healthcare provider will give you Cinqair as an intravenous (IV) infusion in your doctor’s office or a clinic. This is an injection into your vein that’s slowly dripped in over time. So you can’t buy Cinqair in a pharmacy and take it yourself.
Can children use Cinqair?
No. The Food and Drug Administration (FDA) has only approved Cinqair to treat adults. Clinical studies evaluated the use of Cinqair in children ages 12 to 18 years. But the results didn’t show whether the drug worked well and was safe enough to use in children.
If your child has severe eosinophilic asthma, talk with their doctor. They can recommend medications other than Cinqair that can help treat your child.
Will I still need to take a corticosteroid with Cinqair?
Most likely. You’re not meant to take Cinqair by itself. You should use the drug along with your current asthma medications, which may include a corticosteroid.
Cinqair only helps ease severe eosinophilic asthma. This is a type of asthma that’s caused by high levels of eosinophils (a kind of white blood cell) in your blood.
Like Cinqair, corticosteroids work by decreasing inflammation (swelling) in your lungs. However, corticosteroids reduce inflammation in slightly different ways. Many people with severe asthma need Cinqair and a corticosteroid to help control their asthma. Therefore, your doctor may prescribe both medications for you. Don’t stop taking the corticosteroid unless your doctor tells you to.
Will I still need to have a rescue inhaler with me?
Yes. You’ll still need to carry a rescue inhaler if you receive Cinqair.
Even though Cinqair helps treats severe eosinophilic asthma long term, you may still have flare-ups. And Cinqair doesn’t work quickly enough to treat sudden asthma symptoms.
If you don’t manage symptoms of an asthma flare-up right away, they could get worse. So the best way to get a handle on them is to use a rescue inhaler. This device will help ease your asthma symptoms.
Keep in mind that you’ll still need to take your other asthma medications, including Cinqair.
This drug comes with several warnings.
FDA warning: Anaphylaxis
This drug has a
A severe allergic reaction called anaphylaxis may occur after receiving Cinqair. The drug is given by a healthcare provider, so they’ll monitor how your body reacts to Cinqair. They can also treat anaphylaxis quickly if you develop it.
Other warnings
Before taking Cinqair, talk with your doctor about your health history. Cinqair may not be right for you if you have certain medical conditions. These include:
Helminth infection
Cinqair may not be right for you if you have a helminth infection (a parasitic infection that’s caused by worms). Your doctor will need to treat the infection before you can start using Cinqair.
If you get a helminth infection while using Cinqair, your doctor may pause your treatment. They may also prescribe medication to clear up the infection. Once the infection goes away, your doctor may have you start receiving Cinqair again.
Keep in the mind the symptoms of a helminth infection so you know what to look for. Symptoms may include diarrhea, pain in your abdomen, malnutrition, and weaknesses.
Pregnancy
Not enough clinical studies have been done in humans to prove whether Cinqair is safe to use during pregnancy. To learn more, see the “Cinqair and pregnancy” section above.
Note: For more information about the potential negative effects of Cinqair, see the “Cinqair side effects” section above.
The following information is provided for clinicians and other healthcare professionals.
Indications
Cinqair is indicated for the treatment of severe asthma. The drug’s approval is conditioned to its use as an add-on maintenance treatment for severe asthma. Cinqair shouldn’t replace the current treatment approach defined for patients, including the use of corticosteroids.
Cinqair approval is for the treatment of people with an eosinophilic phenotype. The drug shouldn’t be administrated to people with different phenotypes. Neither should it be administrated for the treatment of other eosinophilic-related diseases.
Also, Cinqair isn’t indicated to treat acute bronchospasms or status asthmaticus. The drug’s use to relieve symptoms wasn’t analyzed during clinical studies.
The use of Cinqair should be reserved for people older than age 18 years. It doesn’t have Food and Drug Administration (FDA) approval for people younger than that age.
Mechanism of action
The precise mechanism of action of Cinqair hasn’t been completely elucidated yet. But it’s believed it acts via the interleukin-5 (IL-5) pathway.
Cinqair is a humanized IgG4-kappa monoclonal antibody that binds to IL-5. The binding has a dissociation constant of 81 picomolar (pM). By binding to IL-5, Cinqair antagonizes IL-5 and inhibits its biological activity. This occurs because Cinqair prevents IL-5 from binding to the IL-5 receptor present in the cellular surface of eosinophils.
IL-5 is the most important cytokine for the growth, differentiation, recruitment, activation, and survival of eosinophils. Lack of interaction between IL-5 and eosinophils prevents IL-5 from having these cellular actions in eosinophils. So eosinophil cellular cycle and biological activities get compromised. Eosinophils stop working properly and die.
In people with an eosinophil prototype of severe asthma, eosinophils are an important cause of the disease. Eosinophils cause constant inflammation in the lungs, which leads to chronic asthma. By reducing the number and function of eosinophils, Cinqair reduces the inflammation in the lung. So severe asthma is temporarily controlled.
Mast cells, macrophages, neutrophils, and lymphocytes may also inflame the lungs. In addition, eicosanoids, histamine, cytokines, and leukotrienes may cause this inflammation. It is unknown if Cinqair acts on these cells and mediators to control inflammation in the lungs.
Pharmacokinetics and metabolism
Cinqair achieves its peak concentration at the end of the infusion period. Multiple administrations of Cinqair lead to an accumulation of it in the serum of 1.5- to 1.9-fold. The serum concentrations decline in a biphasic curve. These concentrations don’t change with the presence of anti-Cinqair antibodies.
Once administrated, Cinqair has a volume of distribution of 5 liters. This means that high amounts of Cinqair don’t likely reach extravascular tissues.
As with most monoclonal antibodies, Cinqair suffers enzymatic degradation. Proteolytic enzymes convert it into small peptides and amino acids. Complete proteolysis of Cinqair takes time. Its half-life is approximately 24 days. Also, its clearance rate is approximately 7 milliliters per hour (mL/hr). Target-mediated clearance for Cinqair is unlikely to happen. This is because it binds to interleukin-5 (IL-5), which is a soluble cytokine.
Pharmacokinetics studies of Cinqair are very similar among people of different age, gender, or race. Variability among individuals is between 20% to 30% for peak concentration and overall exposure.
Pharmacokinetics studies show no significant difference between people with normal and mildly increased liver function tests. A normal function involves levels of bilirubin and aspirate aminotransferase less than or equal to the upper limit normal (ULN). A mildly increased function test involves levels of bilirubin above the ULN and less than or equal to 1.5-fold the ULN. It may also involve levels of aspartate aminotransferase higher than the ULN.
Also, pharmacokinetics studies show no difference between people with normal or impaired renal function. Normal renal function implies an estimated glomerular filtration rate (eGFR) greater than or equal to 90 mL per minute per 1.73-meter squared. (mL/min/1.73 m2). Mild and moderate renal functions imply an estimated eGFR between 60 to 89 mL/min/1.73 m2 and 30 to 59 mL/min/1.73 m2, respectively.
Contraindications
Cinqair is contraindicated in people who have previously developed hypersensitivity to any active or inactive ingredient of Cinqair.
Hypersensitivity may happen right after the administration of Cinqair. But in some cases, it may happen within a couple of hours following the drug’s administration. The monitoring of patients after Cinqair administration is important to observe the development of hypersensitivity reactions.
Hypersensitivity is a multi-organ disease that can cause anaphylaxis and death by anaphylactic shock. All patients with hypersensitivity to Cinqair should interrupt treatment immediately. In this case, symptoms of hypersensitivity should be treated. These patients should never receive Cinqair treatment again.
Talk to your patients about the symptoms of hypersensitivity and anaphylaxis. Tell them to call 911 immediately if they think they are having these conditions. Also, tell them to inform their health providers if they experience hypersensitivity or anaphylaxis to redefine the treatment approach.
Storage
Cinqair should be refrigerated between 36°F to 46°F (2°C to 8°C). It’s important that the drug isn’t frozen or shaken. It’s also important to store Cinqair in its original package until its utilization. This will protect the drug from light degradation.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
