Sustained remission induced by 2 years of treatment with benralizumab in patients with severe eosinophilic asthma and nasal polyposis
Corrado Pelaia, Claudia Crimi, Alida Benfante, Maria Filomena Caiaffa, Raffaele Campisi, Claudio Candia, Giovanna Elisiana Carpagnano, Isabella Carrieri, Maria D’Amato, Aikaterini Detoraki, Maria Pia Foschino Barbaro, Nicola Lombardo, Luigi Macchia, Angelantonio Maglio, Elena Minenna, Santi Nolasco, Giuseppe Paglino, Francesco Papia, L Ricciardi, Nicola Scichilone, Giulia Scioscia, Giuseppe Spadaro, Pasquale Tondo, Simona Uletta Lionetti, Giuseppe Valenti, Alessandro Vatrella, Nunzio Crimi, Girolamo Pelaia
Abstract
Abstract Background and Objective Several randomized controlled trials (RCTs) have shown that benralizumab is characterized by a good profile of efficacy and safety, thereby being potentially able to elicit clinical remission on‐treatment of severe eosinophilic asthma (SEA). The main goal of this multicentre observational study was to verify the effectiveness of benralizumab in inducing a sustained remission on‐treatment of SEA in patients with or without comorbid chronic rhinosinusitis with nasal polyps (CRSwNP). Methods Throughout 2 years of treatment with benralizumab, a four‐component evaluation of sustained remission of SEA was performed, including the assessment of SEA exacerbations, use of oral corticosteroids (OCSs), symptom control and lung function. Results The present study recruited 164 patients suffering from SEA. After 24 months of add‐on biological therapy with benralizumab, 69 (42.1%) achieved the important target of sustained remission on‐treatment (exacerbation rate = 0, OCS dose = 0, pre‐bronchodilator FEV 1 ≥80% pred., ACT score ≥ 20). During the same period, a persistent improvement of CRSwNP (SNOT‐22 < 30, NP recurrence = 0) was observed in 33 (40.2%) out of 82 subjects with concomitant NP. The latter comorbidity and post‐bronchodilator reversibility of airflow limitation were two independent predictors of sustained remission on‐treatment (OR = 2.32, p < 0.05 and OR = 5.59, p < 0.01, respectively). Conclusion Taken together, the results of this real‐life clinical investigation indicate that benralizumab can induce a sustained remission on‐treatment of SEA, especially in those patients with comorbid CRSwNP and reversible airflow limitation. image