Could Benralizumab Reduce Exacerbation Rates In Asthma Patients?

A subcutaneous injection of benralizumab every 8 weeks may be effective at reducing the dose of oral glucocorticoid therapy while maintaining asthma control in patients with severe eosinophilic asthma, according to a recent study.

The randomized controlled trial included 220 patients with severe eosinophilic asthma who relied on oral glucocorticoids to manage asthma severity. Patients either received a subcutaneous 30 mg dose of benralizumab every 4 or every 8 weeks or placebo for 28 weeks. Percentage change in oral glucocorticoid dose from baseline to week 28 was assessed as the primary endpoint, and annual asthma exacerbation rates, lung function, symptoms, and safety were included as additional endpoints.
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Overall, the 2 dosing regimens of benralizumab significantly reduced the median oral glucocorticoid doses by 75% from baseline, while the placebo showed a 25% reduction in oral glucocorticoid doses from baseline.

The annual exacerbation rate in participants who received benralizumab every 4 weeks was 55% lower than those who received the placebo. Likewise, participants who received benralizumab every 8 weeks had a 70% lower annual exacerbation rate compared with participants who received the placebo.

However, there were no significant differences between benralizumab regimens and placebo on forced expiratory volume in 1 second, and effects of benralizumab on other asthma symptom measures were mixed.

The frequency of adverse events was similar between both benralizumab regimen groups and the placebo group.

“The likelihood of a reduction in the oral glucocorticoid dose was more than 4 times as high with benralizumab as with placebo, and one half the eligible patients (those receiving a baseline prednisone dose of ≤12.5 mg per day) who were receiving benralizumab stopped the oral glucocorticoid therapy completely,” the researchers concluded.

“In addition to clinically relevant dose reductions or the discontinuation of oral glucocorticoid therapy, patients receiving benralizumab had substantially lower rates of asthma exacerbations than did patients receiving placebo, as well as lower rates of exacerbation-related hospital visits.”

—Melissa Weiss

Reference:

Nair P, Wenzel A, Rabe KF, et al; ZONDA Trial Investigators. Oral glucocorticoid-sparing effect of benralizumb in severe asthma [published online May 22, 2017]. N Engl J Med. doi:10.1056/NEJMoa1703501.