Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Oct 30:40:101763.
doi: 10.1016/j.rmcr.2022.101763. eCollection 2022.

Benralizumab monotherapy was insufficient to induce remission in patients with active eosinophilic granulomatosis with polyangiitis

Osamu Matsuno  1 , Seijiro Minamoto  1
Affiliations
Case Reports

Benralizumab monotherapy was insufficient to induce remission in patients with active eosinophilic granulomatosis with polyangiitis

Osamu Matsuno et al. Respir Med Case Rep. .

Abstract

Eosinophils play an important pathogenetic role in the development of eosinophilic granulomatosis with polyangiitis (EGPA). EGPA has long been treated with systemic corticosteroids and immunosuppressive agents. However, in recent years, biologic agents targeting eosinophils (anti-IL-5 antibody; mepolizumab) have also been used. Evidence regarding the effectiveness of using benralizumab, anti-IL-5 receptor α monoclonal antibody that depletes eosinophils via antibody-dependent cell-mediated cytotoxicity, has been growing. Benralizumab is used as a steroid-sparing treatment option for EGPA. Clinical studies have evaluated the effects of using mepolizumab or benralizumab in combination with steroids for the treatment of EGPA. However, to date, there have been no reports of using biologics alone. Herein, we describe the case of a patient with active EGPA refractory to benralizumab monotherapy. The patient achieved significant improvement in symptoms after administration of corticosteroids during hospitalization. Benralizumab monotherapy might not be considered a therapeutic option for patients with active EGPA in whom corticosteroids are initially indicated.

Keywords: ACR/EULAR, American College Rheumatology (ACR)/ European Alliance of Associations for Rheumatology (EULAR); Benralizumab; CT, computed tomography; Corticosteroid; EGPA, eosinophilic granulomatosis with polyangiitis; Eosinophilic granulomatosis with polyangiitis; IL, interleukin; MPO-ANCA, myeloperoxidase anti-neutrophil cytoplasmic antibody.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
(a) Chest radiograph showed an infiltrative shadow in the right upper lung field. (b) Chest CT showed multiple graund-glass shadows on the outer side of the right lung.
Fig. 2
Fig. 2
(a) Skin lesion presenting as purpuric bullous rash in lower limbs, and an ulceration. (b) Skin biopsy specimens of the lower limbs showed fibrinoid necrosis and eosinophil infiltration in the peripheral blood vessels (c) Foci of histiocytes around blood vessels and peripheral nerves in the deep dermis.
See this image and copyright information in PMC

References

    1. Gokhale M., Bell C.F., Doyle S., et al. Prevalence of eosinophilic granulomatosis with polyangitis and associated health care utilization among patients with concomitant asthma in US commercial claims database. J. Clin. Rheumatol. 2019;27:107–113. doi: 10.1097/rhu.0000000000001198. - DOI - PMC - PubMed
    1. Groh M., Pagnoux C., Baldini C., et al. Eosinophilic granulomatosis with polyangiitis (Churg-Strauss)(EGPA) Consensus Task Force recommendations for evaluation and management. Eur. J. Intern. Med. 2015;26:545–553. doi: 10.1016/j.ejim.2015.04.022. - DOI - PubMed
    1. Wechsler M.E., Akuthota P., Jayne D., et al. Mepolizumab or placebo for eosinophilic granulomatosis with polyangiitis. N. Engl. J. Med. 2017;376:1921–1932. doi: 10.1056/NEJMoa1702079. - DOI - PMC - PubMed
    1. Chica-Guzmán M.V., Morillo-Guerrero R., Carrón-Herrero A., González-de-Olano D., Almonacid-Sánchez C. Eosinophilic granulomatosis with polyangiitis successfully treated with benralizumab. Ann. Allergy Asthma Immunol. 2020;125:228–230. doi: 10.1016/j.anai.2020.05.002. - DOI - PubMed
    1. FitzGerald J.M., Bleecker E.R., Nair P., Korn S., Ohta K., Lommatzsch M., Ferguson G.T., Busse W.W., Barker P., Sproule S., Gilmartin G., Werkström V., Aurivillius M., Goldman M. CALIMA study investigators, Benralizumab, an anti-interleukin-5 receptor α monoclonal antibody, as add-on treatment for patients with severe, uncontrolled, eosinophilic asthma (CALIMA): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2016;388:2128–2141. doi: 10.1016/S0140-6736(16)31322-8. - DOI - PubMed

Publication types