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. 2025 Mar 12;13(3):e70117.
doi: 10.1002/rcr2.70117. eCollection 2025 Mar.

Out of Breath, out of Options: Benralizumab as a Last Hope in ICU-Treated Near-Fatal Eosinophilic Asthma: A Case Series

Lennart Conemans  1   2 , Emel Demir  3 , Martijn Bischoff  4 , Frits Franssen  1   2   5 , Sami Simons  1   2
Affiliations

Out of Breath, out of Options: Benralizumab as a Last Hope in ICU-Treated Near-Fatal Eosinophilic Asthma: A Case Series

Lennart Conemans et al. Respirol Case Rep. .

Abstract

Asthma exacerbations remain life-threatening events despite advancements in biologic therapies. This case series reports on four patients with near-fatal eosinophilic asthma exacerbations who had been admitted to intensive care and were treated with benralizumab as a last resort after failing maximal standard therapies. All patients exhibited marked blood or airway eosinophilia and required intensive care ventilatory support. Following the administration of benralizumab, significant clinical improvements were observed. This series highlights the potential role of benralizumab in treating life-threatening asthma exacerbations driven by eosinophilic airway inflammation and underlines the need for phenotyping and timely intervention in managing such patients with near-fatal asthma while also stressing the need for continued adherence to asthma guidelines to prevent these extreme situations.

Keywords: ICU; asthma exacerbations; benralizumab; near‐fatal asthma; severe asthma.

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Conflict of interest statement

L.C. received honoraria for lectures from AstraZeneca, GlaxoSmithKline, and Sanofi. He is indirectly involved in a research grant provided by AstraZeneca. F.F. received honoraria for lectures and consultancies from AstraZeneca, Chiesi, GlaxoSmithKline, MSD, Pfizer, and Sanofi. In addition, he received scientific writing support from AstraZeneca, Chiesi, and Novartis. Also, he received research grants from AstraZeneca. S.S. received grants from Roche, Dutch Research Council, and Lung foundation Netherlands. Also, he received honoraria for lectures and consultancies from AstraZeneca, Chiesi, and GlaxoSmithKline.

Figures

FIGURE 1
FIGURE 1
Ventilator peak pressures are shown for the individual patients. On day 0 benralizumab was administered.
FIGURE 2
FIGURE 2
Respiratory system resistance is shown for three patients. On day 0 benralizumab was administered. For patient 2, resistance values are missing because the ventilator's specifications did not allow for this measurement.
See this image and copyright information in PMC

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