Real-Life effects of benralizumab on exacerbation number and lung hyperinflation in atopic patients with severe eosinophilic asthma

Biomed Pharmacother. 2020 Sep:129:110444. doi: 10.1016/j.biopha.2020.110444. Epub 2020 Jun 24.

Abstract

Background: The humanized monoclonal antibody benralizumab targets the α subunit of the interleukin-5 (IL-5) receptor and the FcγRIIIa receptor expressed by natural killer cells. Through this dual mechanism of action, benralizumab neutralizes the pro-eosinophil functions of IL-5 and promotes eosinophil apoptosis.

Objectives and methods: The present real-life study aimed to evaluate, in 22 allergic patients with severe eosinophilic asthma, the effects of benralizumab on asthma exacerbations and lung hyperinflation.

Results: In this regard here we show that, after 24 weeks of add-on treatment, benralizumab completely depleted peripheral blood eosinophils (from 810 to 0 cells/μL; p < 0.0001), and significantly decreased both asthma exacerbation number (from 4 to 0; p < 0.0001) and residual volume (from 2720 to 2300 mL; p < 0.01). Moreover, at the same time point (24 weeks) benralizumab also increased pre-bronchodilator FEV1 (from 1295 to 1985 mL; p < 0.0001), FVC (from 2390 to 2974 mL; p < 0.0001), FEF25-75 (from 0.6 to 1.42 L/sec; p < 0.0001), IC (from 1940 to 2460 mL; not significant), and ACT score (from 14.73 to 22.95; p < 0.0001), as well as reduced prednisone intake (from 25 to 0 mg; p < 0.0001).

Conclusion: In conclusion, our results suggest that via its anti-eosinophil actions benralizumab improved airflow limitation, lung hyperinflation, and respiratory symptoms, as well as lowered asthma exacerbation rate and abrogated OCS consumption in most patients.

Keywords: Allergy; Benralizumab; Eosinophils; Exacerbations; IL-5 receptor; Lung hyperinflation; Severe asthma.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Anti-Asthmatic Agents / adverse effects
  • Anti-Asthmatic Agents / therapeutic use*
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Asthma / diagnosis
  • Asthma / drug therapy*
  • Asthma / physiopathology
  • Disease Progression
  • Drug Therapy, Combination
  • Eosinophilia / blood
  • Eosinophilia / diagnosis
  • Eosinophilia / drug therapy*
  • Female
  • Forced Expiratory Volume
  • Glucocorticoids / administration & dosage
  • Humans
  • Lung / drug effects*
  • Lung / physiopathology
  • Male
  • Maximal Midexpiratory Flow Rate
  • Middle Aged
  • Prednisone / administration & dosage
  • Retrospective Studies
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome
  • Vital Capacity

Substances

  • Anti-Asthmatic Agents
  • Antibodies, Monoclonal, Humanized
  • Glucocorticoids
  • benralizumab
  • Prednisone