Effectiveness of anti-IL-5Rα-therapy in patients with T2-inflammatory airway diseases in real clinical practice

Abstract

Introduction. There is insufficient data on effectiveness and safety of targeted drugs aimed at T2 inflammation in real-life practice.Aim. To evaluate benralizumab effectiveness in patients with T2-inflammatory airway diseases in real-life clinical practice and to identify predictors of a positive response to therapy.Materials and methods. Patients' data from Sverdlovsk region registry with non-allergic eosinophilic (n = 32) and mixed (n = 6) severe asthma received benralizumab were analyzed. Reduction in proportion of patients requiring systemic GCS and proportion of patients with a good response to therapy according to BARS were the main endpoints. Dynamics in ACT score, basic therapy, asthma exacerbations frequency, emergency calls and hospitalizations, FEV1 and eosinophil blood count, scores in AQLQ, SNOT-22 and VAS were also evaluated. Control visits were conducted at baseline, after 4 and 12 months of benralizumab administration. Analysis of good response predictors to benralizumab was performed.Results. Over 12 months of benralizumab therapy, the proportion of patients requiring systemic GCS decreased by 81.8%. According to BARS, a good response to therapy was demonstrated by 69.6% of patients (n = 16), satisfactory - 21.7% (n = 5), and insufficient - 8.7% (n = 2). Significant positive dynamics were observed in asthma control level, therapy volume (doses of inhaled GCS, intake of LABA, SABA), frequency of asthma exacerbations and hospitalizations, FEV1 and eosinophil blood count, AQLQ, SNOT-22 and VAS questionnaires. Patients with insufficient response to benralizumab had high initial blood eosinophilia.Conclusions. In real clinical practice, benralizumab improves asthma control, reduces frequency of asthma exacerbations even in discontinuation of SGCS and reduction of basic therapy, improves lung function, quality of life, and reduces nasal symptoms in patients with concomitant inflammatory nasal diseases. A possible predictor of insufficient response to benralizumab was high initial eosinophilia (>2330 cells/μl).