Benralizumab in Real-World Severe Eosinophilic Asthma

By Patrick Daly - Last Updated: May 8, 2023

In the ZEPHYR 2 trial, researchers evaluated real-world outcomes and the long-term impact of benralizumab among patients with severe eosinophilic asthma and differing clinical characteristics. This was the largest real-world study on benralizumab according to the study’s lead author, Donna Carstens.

According to the article, published in The Journal of Allergy and Clinical Immunology: In Practice, benralizumab induced “significantly improved asthma control” in real-world patients, including those who switched from other biologic treatments, were treated for up to 24 months, or had blood eosinophil levels counts ranging from <150 cells/μl to ≥300 cells/μl.

Researchers enrolled 429 patients who had 2 or more exacerbations during the 12 months before their benralizumab start date, which was used as the index. Treatments took place from November 2017 to June 2019, and patients were evaluated via medical, laboratory, and pharmacy US insurance claims data.

Benralizumab Impact on Asthma Exacerbation Rate

The primary end point was exacerbation rate in the 12 months after indexing compared with the previous 12 months. Patient subgroups included those who switched from a previous biologic (n=349), had longer-term follow-up of 18 to 24 months (n=419), or had blood eosinophil counts of <150, ≥150, 150-299, <300, and ≥300 cells/μl.

Reportedly, benralizumab decreased exacerbation rates from a pre-index range of 3.10-3.55 per patient year (PPY) to a post-index range of 1.1-1.72 PPY across all blood eosinophil count subgroups, representing a 52% to 64% decrease (P<.00).

Researchers observed similar reductions of 3.25 to 1.25 PPY (62%) and 3.81 to 1.78 PPY (53%) among patients who switched to benralizumab from omalizumab or mepolizumab, respectively. Patients with extended follow-up demonstrated comparable decreases after 18 months (3.38 to 1.18 PPY; 65%) or 24 months (3.38 to 1.08 PPY; 68%) of treatment (P<0.001). The authors noted 39% and 49% of these patients had no exacerbations in months 0-12 and 12-24 post-index, respectively.

The study’s authors ultimately suggested the real-world data supported the efficacy of benralizumab for achieving asthma symptom control across differing subgroups of patients with severe eosinophilic asthma.

“These findings support benralizumab as a valuable therapeutic option in the management of severe eosinophilic asthma,” they closed.

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