Efficacy of Benralizumab in severe asthma in real life and focus on nasal polyposis. (September 2020)

• Record Type: Journal Article
• Authors: Bagnasco, Diego; Brussino, Luisa; Bonavia, Marco; Calzolari, Elisa; Caminati, Marco; Caruso, Cristiano; D'Amato, Maria; De Ferrari, Laura; Di Marco, Fabiano; Imeri, Gianluca; Di Bona, Danilo; Gilardenghi, Andrea; Guida, Giuseppe; Lombardi, Carlo; Milanese, Manlio; Nicolini, Antonello; Riccio, Anna Maria; Rolla, Giovanni; Santus, Pierachille; Senna, Gianenrico; Passalacqua, Giovanni
• Is Part Of: Respiratory medicine. Volume 171(2020)
• Publication Date: 2020-09
• Subjects: Severe asthma -- Nasal polyposis -- Benralizumab -- Real life -- Anti IL-5r; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2020.106080
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Introduction: Severe asthma occurs in 5–10% of asthmatic patients, with nasal polyposis as one of the most frequent comorbidity. Benralizumab was recently marketed, thus we could analyse its effects in real-life in severe asthma, and compare the effects of the drug in patients with and without polyposis. Methods: Patients with severe asthma, receiving Benralizumab were enrolled in Italian asthma centres. The efficacy criteria for asthma (exacerbation rate, oral corticosteroid intake, hospitalizations, pulmonary function, exhaled nitric oxide) were evaluated at baseline and after 24 weeks of treatment. Patients were then sub-analysed according to the presence/absence of nasal polyposis. Results: Fifty-nine patients with severe uncontrolled asthma (21 males, age range 32–78) and treated with benralizumab for at least 24 weeks has been evaluated, showing significant improvements in asthma-related outcomes, except for pulmonary function and exhaled nitric oxide. This included a reduction in the sino-nasal outcome-22 score versus baseline of 13.7 points (p = .0037) in the 34 patients with nasal polyposis. Anosmia disappeared in 31% patients (p = .0034). When comparing the groups with and without nasal polyposis, a similar reduction of exacerbations was seen, with a greater reduction of the steroid dependence in patients with polyposis (−72% vs −53%; p < .0001), whereas lung function was significantly more improved (12% vs 34%, p = .0064) without polyposis patients. Conclusions: Benralizumab, after 6 months of treatment, confirmed its efficacy in severe asthma, and also in nasal polyposis, which is the most frequent comorbidity. The efficacy of Benralizumab in reducing steroid dependence was even higher in patients with polyposis. Highlights: Treatment of severe asthma is deeply changed with the development of biologicals. Benralizumab is effective both in RCTs and in real-life setting. CRSwNP is a common comorbidity in severe asthmatic people. Benralizumab proved to be effective both in patients with or without CRSwNP. Benralizumab proved to be effective in reducing nasal symptoms in CRSwNP patients.