Benralizumab Deemed Effective for Eosinophilic Asthma

The anti-eosinophilic, anti-interleukin-5 receptor α monoclonal antibody benralizumab is associated with an improvement in annual exacerbations among patients with severe uncontrolled eosinophilic asthma, according to a recent analysis.

Previous studies have shown that benralizumab is associated with improved lung function and a significant reduction in asthma exacerbations among patients with severe, uncontrolled asthma.
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For their analysis, the researchers assessed the results from the SIROCCO and CALIMA studies. During these studies, 2295 patients with severe, uncontrolled asthma had been randomly assigned to receive subcutaneous benralizumab 30 mg either every 4 weeks (n=756) or every 8 weeks, with the first 3 doses administered every 4 weeks (n=762); or placebo every 4 weeks (n=777).

The primary outcome was annual exacerbation rate (AER) ratio compared with placebo. This was analyzed using baseline eosinophil counts (0 or more, 150 or more, 300 or more, or 450 cells or more per μL) and number of exacerbations (2 vs 3 or more) within the year before enrollment. The intention-to-treat principle was used to conduct analyses.

Results indicated that AER among patients with baseline blood eosinophil counts of at least 0 cells per μL had been 0.75 among patients on benralizumab compared with 1.16 in patients on placebo. AER had been 0.73 among patients who received benralizumab every 4 weeks who had eosinophil counts of 0 or more cells per μL. Additionally, rate ratio vs placebo was 0.63.

The researchers found that the extent to which exacerbation rates were reduced among patients in the 4-weekly and 8-weekly benralizumab groups had increased with increasing blood eosinophil thresholds and with greater exacerbation history. Ultimately, benralizumab was associated with greater improvements in AER vs placebo for patients with both high blood eosinophil thresholds and a history of more frequent exacerbations.

“These results will help to guide clinicians when they are deciding whether to use benralizumab to treat patients with severe, uncontrolled, eosinophilic asthma,” the researchers concluded.

—Christina Vogt

Reference:

FitzGerald JM, Bleecker ER, Menzies-Gow A, et al. Predictors of enhanced response with benralizumab for patients with severe asthma: pooled analysis of the SIROCCO and CALIMA studies [Published online September 11, 2017]. The Lancet Respir Med. http://dx.doi.org/10.1016/S2213-2600(17)30344-2.