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Multicenter Study
. 2024 Oct;54(10):734-746.
doi: 10.1111/cea.14544. Epub 2024 Jul 31.

Overcoming Barriers to Remission in Severe Eosinophilic Asthma: Two-Year Real-World Data With Benralizumab

David J Jackson  1   2 , Hassan Burhan  3   4 , Hitasha Rupani  5 , Paul E Pfeffer  6 , Ian J Clifton  7 , Shoaib Faruqi  8 , Jaideep Dhariwal  1 , Pujan Patel  9 , Tamsin Morris  10 , Joseph Lipworth  10 , Michael Watt  10 , Charlotte Lupton  10 , Sabada Dube  10 , Joe Hickey  11 , Alexandra M Nanzer  1   2
Affiliations
Multicenter Study

Overcoming Barriers to Remission in Severe Eosinophilic Asthma: Two-Year Real-World Data With Benralizumab

David J Jackson et al. Clin Exp Allergy. 2024 Oct.

Abstract

Background: Benralizumab has been reported to lead to clinical remission of severe eosinophilic asthma (SEA) at 1 year in some patients. However, whether this is maintained over a longer term remains unclear. Additionally, the impact of pulmonary and extrapulmonary comorbidities on the ability to meet remission is poorly understood.

Methods: Clinical outcomes including remission of SEA with benralizumab at 1 and 2 years were assessed retrospectively in a real-world UK multi-centre severe asthma cohort. The presence of clinically relevant pulmonary and extrapulmonary comorbidities associated with respiratory symptoms was recorded. Analyses to identify factors associated with the ability to meet remission were performed.

Results: In total, 276 patients with SEA treated with benralizumab including 113 patients who had switched from a previous biologic to benralizumab were included. Overall, clinical remission was met in 17% (n = 31/186) and 32% (n = 43/133) of patients at 1 and 2 years, respectively. This increased to 28% at 1 year and 49% at 2 years once patients with pulmonary and/or extrapulmonary comorbidities were excluded. Body mass index (BMI) and maintenance OCS (mOCS) use demonstrated a negative association with clinical remission at 1 (BMI: OR: 0.89, 95% CI: 0.82-0.96, p < 0.01; mOCS: OR: 0.94, 95% CI: 0.89-0.99, p < 0.05) and 2 years (BMI: OR: 0.93, 95% CI: 0.87-0.99, p < 0.05; mOCS: OR: 0.95, 95% CI: 0.89-0.99, p < 0.05).

Conclusions: In this long-term, real-world study, patients with SEA demonstrated the ability to meet and sustain clinical remission when treated with benralizumab. The presence of comorbidities including obesity, which are known to be independently associated with respiratory symptoms, reduced the likelihood of meeting clinical remission.

Keywords: asthma; benralizumab; real‐world; remission; severe eosinophilic asthma.

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