Abstract
BackgroundBenralizumab, an anti-interleukin-5 (IL-5) receptor α monoclonal antibody, significantly reduces the number of annual exacerbations and oral corticosteroid (OCS) maintenance doses for patients with severe eosinophilic asthma (SEA). However, few studies on the efficacy of this biologic in real life are available. The aim was to elucidate the efficacy of benralizumab by evaluating changes in clinical parameters after benralizumab treatment in patients with SEA.MethodsFrom July 2018 to December 2019, 24 Japanese patients with SEA received benralizumab at Jikei University Hospital. We retrospectively evaluated the patients’ characteristics, parameters, numbers of exacerbations and maintenance OCS doses.ResultsAmong the 24 patients, eleven patients had received mepolizumab treatment and were directly switched to benralizumab. The peripheral blood eosinophil and basophil counts significantly decreased after benralizumab treatment regardless of previous mepolizumab treatment. Pulmonary function, Asthma Control Test scores, the numbers of annual exacerbations and maintenance OCS doses in patients without previous mepolizumab treatment tended to improve without significant differences. Fourteen patients (58%) were responders according to the Global Evaluation of Treatment Effectiveness (GETE) score. The proportion of GETE responders among patients with aspirin-exacerbated respiratory disease (AERD) tended to be lower than that among patients without AERD (p = 0.085). After benralizumab treatment, the change in the forced expiratory volume in 1 s from baseline was 200 ml or greater in eight patients (33%), including three patients who were switched from mepolizumab.ConclusionBenralizumab treatment improved and controlled asthma symptoms based on the GETE score.
Highlights
Benralizumab, an anti-interleukin-5 (IL-5) receptor α monoclonal antibody, significantly reduces the number of annual exacerbations and oral corticosteroid (OCS) maintenance doses for patients with severe eosinophilic asthma (SEA)
Benralizumab treatment improved and controlled asthma symptoms based on the Global Evaluation of Treatment Effectiveness (GETE) score
11 had directly switched to benralizumab from mepolizumab treatment based on asthma symptoms (n = 2), the interval between hospital visits (n = 6) and discussions with physicians (n = 3) (Additional file 1)
Summary
Benralizumab, an anti-interleukin-5 (IL-5) receptor α monoclonal antibody, significantly reduces the number of annual exacerbations and oral corticosteroid (OCS) maintenance doses for patients with severe eosinophilic asthma (SEA). Severe and uncontrolled asthma has been reported to be associated with diminished health-related quality of life and high healthcare costs [4, 5]. Benralizumab has been demonstrated to be an effective therapy for patients with severe eosinophilic asthma (SEA) as it reduces annual exacerbation rates and maintenance oral corticosteroid (OCS) doses and improves pulmonary function [6,7,8,9]. An anti-IL-5 monoclonal antibody, has shown clinical efficacy for patients with SEA in Japan [10, 11], little evidence is available regarding benralizumab therapy for patients with severe asthma [12]
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