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Benralizumab has been shown to restore good control of severe eosinophilic asthma (SEA). Robust data on benralizumab effectiveness over periods longer than 2 years are scarce. This retrospective multicentric study was conducted on 108 Italian SEA patients treated with benralizumab for up to 36 months. Partial and complete clinical remission (CR) were assessed. Data were analyzed with descriptive statistics or using linear, logistic, and negative binomial mixed-effect regression models. At 36 months, benralizumab reduced the exacerbation rate by 89% and increased the forced expiratory volume in 1 second (FEV) (+440 mL at 36 months, < 0.0001). Benralizumab improved asthma control as well as sinonasal symptoms in patients with chronic rhinosinusitis with nasal polyposis (CRSwNP). Up to 93.33% of patients either reduced or discontinued OCS; benralizumab also decreased ICS use and other asthma medications. Overall, 84.31% of patients achieved partial or complete CR. Benralizumab improved asthma and sinonasal outcomes up to 36 months. These findings support the potential of benralizumab to induce CR, emphasizing its role as a disease-modifying anti-asthmatic drug for the management of SEA. Further research is warranted to expand these findings by minimizing data loss and assessing benralizumab's long-term safety.
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http://dx.doi.org/10.3390/jcm13103013 | DOI Listing |
J Med Cases
August 2025
Department of Hematology/Oncology, Mayo Clinic, Jacksonville, FL, USA.
Hypereosinophilic syndrome (HES) is a hematologic disorder characterized by an increased absolute eosinophil count (AEC) that can lead to tissue infiltration and damage. Idiopathic HES (iHES) comprises a subset of patients with HES, in which a reactive cause such as infections or an inflammatory process cannot be identified, and clonality is not demonstrable. iHES remains a challenge to treat since there is no specific mutation to target.
View Article and Find Full Text PDFJ Allergy Clin Immunol Pract
September 2025
Observational and Pragmatic Research Institute, Singapore, Singapore; Optimum Patient Care Global, Cambridge, UK; Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK. Electronic address:
Background: Asthma with low levels of T2-biomarkers is poorly understood.
Objective: To characterize severe asthma phenotypes and compare pre- to post-biologic change in asthma outcomes along a gradient of T2-involvement.
Methods: This was a registry-based, cohort study including data from 24 countries.
J Allergy Clin Immunol Glob
November 2025
Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka, Japan.
Eosinophilic granulomatosis with polyangiitis can manifest without eosinophilia and eosinophilic infiltration during benralizumab treatment, emphasizing the need for clinical vigilance beyond eosinophil counts.
View Article and Find Full Text PDFACR Open Rheumatol
September 2025
University of Pennsylvania, Philadelphia.
Objective: In the phase 3 head-to-head MANDARA study (NCT04157348), benralizumab demonstrated noninferiority to mepolizumab in inducing remission (defined as Birmingham Vasculitis Activity Score [BVAS] of 0 and oral glucocorticoid [OGC] dosage ≤4 mg/day at weeks 36 and 48) in patients with eosinophilic granulomatosis with polyangiitis (EGPA). This analysis investigated a more stringent definition of remission that included discontinuation of OGCs and being relapse-free.
Methods: Patients aged ≥18 years with documented relapsing or refractory EGPA receiving OGCs at ≥7.
J Asthma
September 2025
Pulmonology Consultant, Severe Asthma Multidisciplinary Unit, Thorax Department - Unidade Local de Saúde Santa Maria, Portugal. ISAMB - Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
Severe asthma is a heterogeneous disease involving multiple inflammatory pathways, with significant therapeutic challenges. Biologic therapies targeting T2 inflammation improve outcomes but may, in rare cases, trigger hypersensitivity reactions due to anti-drug antibodies, excipients, or protein structure. Additionally, some patients exhibit suboptimal or no response.
View Article and Find Full Text PDF