Abstract
To evaluate the effectiveness of benralizumab in patients with the eosinophilic phenotype of severe asthma in real clinical practice after a year of therapy.Methods. During Benralizumab therapy, 13 patients with severe eosinophilic asthma (average age – 55.44 ± 7.18 years old) were examined twice: before the treatment and after 1 year of benralizumab therapy. The assessment included collection of complaints, medical history, current therapy, Asthma Control Questionnaire (ACQ-5) test, absolute blood count of eosinophils, spirometry.Results. All patients initially had pronounced eosinophilia of 577.5 ± 356.4 cells/μl. After 1 year of using benralizumab, the eosinophil count decreased by 96.15%. During therapy, the ACQ-5 index decreased from 1.63 ± 0.62 to 0.73 ± 0.41 in the study patients, which corresponded to the achievement of asthma control. The forced expiratory volume in 1 second (FEV1) increased by 23 %. The number of exacerbations decreased by 58.09%. 12 (92.31%) patients were on oral corticosteroids (OCS) (10 ± 2.17 mg of prednisolone daily) before benralizumab therapy. All subjects noted a decrease in night and day symptoms over time and were able to reduce the use of OCS. 5 (38.46%) patients achieved complete elimination of daily OCS use, 7 (53.84%) patients were able to reduce their daily OCS dose.Conclusion. Benralizumab therapy as an add-on maintenance treatment in patients with eosinophilic phenotype of severe asthma contributes to a significant decrease in peripheral blood eosinophils, which mediates an improvement in asthma control, an increase in FEV1, a reduction in the number of exacerbations, and a decrease in the need for the OCS usage. Careful monitoring of long-term adverse events is necessary during treatment with benralizumab.
Highlights
To evaluate the effectiveness of benralizumab in patients with the eosinophilic phenotype of severe asthma in real clinical practice after a year of therapy
Через 1 год терапии у всех больных продемонстрировано увеличение этого показателя до 60,28 ± 12,3 %
All the authors made a significant contribution to the search and analytical work and the preparation of the article, read and approved the final version before publication
Summary
Исследование проводилось на базе Городского пульмонологического центра Санкт-Петербургского государственного бюджетного учереждения здравоохранения «Введенская городская клиническая больница». Обследование проводилось амбулатороно дважды – до начала лечения и через 1 год терапии бенрализумабом. В анализе крови у всех пациентов исходно отмечена выраженная эозинофилия – 577,5 ± 356,4 (300–1 600) клеток / мкл. Через 1 год использования бенрализумаба у 11 (84,61 %) пациентов не выявлено эозинофилов в крови, у 2 определен уровень 100 клеток / мкл, что соответствовало уменьшению выраженности эозинофилии на 96,15 % На фоне терапии бенрализумабом у наблюдаемых пациентов показатель ACQ-5 снизился с 1,63 ± 0,62 (неконтролируемая БА) до 0,73 ± 0,41 балла, что соответствовало достижению контроля над заболеванием. Через 1 год терапии у всех больных продемонстрировано увеличение этого показателя до 60,28 ± 12,3 % 1. Динамика количества эозинофилов крови у больных тяжелой бронхиальной астмой на фоне терапии бенрализумабом в течение 1 года
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