Study Shows Benralizumab Effective as an Add-On Treatment for Severe Eosinophilic Asthma

Carla Maria Irene Quarato

Severe eosinophilic asthma can cause airway hyperresponsiveness, worsening symptoms, and decreased lung function for patients, often leading to recurrent or maintenance corticosteroid use and deeply conditioning patients quality of life.

A team, led by Carla Maria Irene Quarato, University of Foggia, determined if and how an add-on treatment with benralizumab could improve the quality of life of patients with severe eosinophilic asthma in data at the European Respiratory Society International Congress 2020 (ERS 2020)​.

The study included 10 outpatients with severe eosinophilic asthma, 7 of which were female. Each patient received treatment added-on with benralizumab and was followed-up with in an accredited outpatient clinic for severe asthma at 12 and 24 weeks.

The investigators assessed quality of life during each visit using the Asthma Quality of Life Questionnaire (AQLQ), EuroQol-visual analogue scales (EQ-VAS), and EuroQol-5Dimensions-3Levels (EQ-3D-5L).

The researchers found both a significant reduction in eosinophilic inflammation, exacerbations, and gaining in pre-bronchodilator FEV1 and symptoms control, with all the enrolled subjects experiencing an improvement in AQLQ [from 3.65±0.56 (baseline) to 4.61±0.67 (12 weeks) (P = 0.003) and to 5.17±0.87 (24 weeks) (P = 0.0002)].

This covered all 4 health domains—symptoms perception, activity limitation, emotional function, and environmental stimuli—investigated (P <0.05).

The patients also saw an improvement in EQ-VAS (from 44.5±7.7% (baseline) to 60.5±6.6% (12 weeks) (P = 0.002) and to 86.7±7.2% (24 weeks) (P <0.001), with a statistically significant reduction in severe limitation in all dimensions—mobility, self-care, daily activities, pain/discomfort and anxiety/depression (P <0.001).

“Our real life experience confirms the effectiveness of benralizumab as an add-on treatment in restoring patients with severe eosinophilic asthma to a better [quality of life] perception already after 12 weeks of treatment,” the authors wrote.

Recent study findings from the ANDHI trial further back the efficacy and safety of benralizumab for patients with severe asthma.

The study extended knowledge and understanding of the efficacy and safety of benralizumab for severe eosinophilic asthma patients, including the onset of effect and additional health-related quality of life measures.

They included adult patients with severe eosinophilic asthma with at least 2 prior-year exacerbations despite high-dosage inhaled corticosteroid plus additional controllers and screening blood eosinophil counts of at least 150 cells/µL.

Patients were randomized 2:1 to either 24 weeks of benralizumab 30 mg every 8 weeks or placebo.

Nasal polyposis was present for 34.2% of those in the benralizumab group and 35.8% of placebo patients, with a mean SNOT-22 of 51.5 for benralizumab versus 48.2 for placebo. The team found benralizumab significantly improved asthma exacerbation rate, with a 49% reduction versus placebo (.94 vs 1.86; P <.0001).

There was also a clinically meaningful and statistically significant improvement in least-squares mean change in SGRQ total score at week 24 versus placebo (delta-8.11; P <.0001), with similar differences at earlier times throughout the study period. Benralizumab improved lung function, ACQ-6, and SNOT-22 at week 24 versus placebo.

The study, “Benralizumab effectiveness on quality of life of severe eosinophilic asthmatics in real life,” was published online by ERS 2020.