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
. 2023 Dec;82(12):1580-1586.
doi: 10.1136/ard-2023-224624. Epub 2023 Aug 7.

Benralizumab for eosinophilic granulomatosis with polyangiitis

Adrien Cottu  1 , Matthieu Groh  2 , Charlene Desaintjean  3 , Sylvain Marchand-Adam  4 , Loïc Guillevin  1 , Xavier Puechal  1 , Stacy Beaumesnil  5 , Estibaliz Lazaro  5 , Maxime Samson  6 , Camille Taille  7 , Cécile-Audrey Durel  8 , Elizabeth Diot  9 , Sarah Nicolas  9 , Laurent Guilleminault  10   11 , Mikael Ebbo  12 , Pascal Cathebras  13 , Clairelyne Dupin  14 , Halil Yildiz  15 , Nabil Belfeki  16 , Grégory Pugnet  17 , Pierre Chauvin  18 , Stephane Jouneau  19 , Francois Lifermann  20 , Jean-Philippe Martellosio  21 , Vincent Cottin  3 , Benjamin Terrier  22   23 ; French Vasculitis Study Group
Affiliations

Benralizumab for eosinophilic granulomatosis with polyangiitis

Adrien Cottu et al. Ann Rheum Dis. 2023 Dec.

Abstract

Background: Benralizumab is effective in the treatment of eosinophilic asthma and is being investigated for the treatment of other eosinophil-associated diseases. Reports on the use of benralizumab for the treatment of eosinophilic granulomatosis with polyangiitis (EGPA) are limited to case reports and small case series.

Methods: We conducted a multicentre, retrospective study including EGPA patients treated with off-label benralizumab. The primary endpoint was the rate of complete response defined as no disease activity (Birmingham Vasculitis Activity Score=0) and a prednisone dose ≤4 mg/day. Partial response was defined as no disease activity and a prednisone dose ≥4 mg/day.

Results: Sixty-eight patients were included, including 31 (46%) who had previously received mepolizumab. The use of benralizumab was warranted by uncontrolled asthma in 54 (81%), persistent ear, nose and throat (ENT) manifestations in 27 (40%) and persistent glucocorticoids (GCs) use in 48 (74%) patients. Median (IQR) follow-up after starting benralizumab was 23 (9-34) months. Thirty-three patients (49%) achieved a complete response, 24 (36%) achieved a partial response and 10 (15%) did not respond. Among the 57 patients who initially responded, 10 (18%) eventually required further line treatments. GCs were discontinued in 23 patients (38%). Prior mepolizumab use was associated with a higher rate of primary failure (26.7% vs 5.4%, p=0.034) and less frequent GCs discontinuation (14.8% vs 55.9%, p=0.001). Vasculitis flares occurred in 7 patients (11%) and were associated with histological evidence of vasculitis and/or antineutrophil cytoplasmic antibodies positivity at benralizumab initiation (p=0.004).

Conclusions: Benralizumab appears to be an effective treatment for refractory asthma or ENT manifestations in EGPA and allows GC-sparing. However, its efficacy was lower after prior failure of mepolizumab.

Keywords: Biological Therapy; Glucocorticoids; Systemic vasculitis; Treatment.

PubMed Disclaimer

Conflict of interest statement

Competing interests: The authors declare no financial support. MG reports personal fees from GlaxoSmithKline and AstraZeneca outside the submitted work. CT reports personal fees from AstraZeneca, Sanofi, GlaxoSmithKline, Chiesi and Novartis outside the submitted work. CDupin reports personal fees from AstraZeneca and GlaxoSmithKline outside the submitted work. HY reports personal fees from GlaxoSmithKline outside the submitted work. Other authors has nothing to disclose.

MeSH terms