Abstract
Benralizumab therapy for severe eosinophilic asthma demonstrates a heterogeneous clinical response. Identification of patients who rapidly achieve clinical remission and analysis of their baseline characteristics are essential for the personalization of biologic therapy.
AIMSto characterize the clinical and functional profile of patients with a rapid positive response to benralizumab therapy within 4-6 months.
MATERIALS AND METHODS A single-center, retrospective, observational study was conducted. The analysis included 45 adult patients with uncontrolled severe eosinophilic asthma and a baseline blood eosinophil count 300 cells/µL who received benralizumab in a real-world clinical setting for 4-6 months. Super-response was defined as the simultaneous achievement of four criteria: absence of exacerbations, discontinuation of maintenance systemic corticosteroid therapy, an Asthma Control Test (ACT) score ≥20, and an increase in pre-bronchodilator forced expiratory volume in 1 second (FEV₁) ≥100 mL. Baseline demographic, clinical, laboratory, and functional parameters, along with their dynamics, were assessed.
RESULTSThe super-response criteria were met by 8 out of 45 patients (17.8%). Compared to the remaining participants, super-responders were characterized by a significantly shorter duration of asthma (median 6.0 years vs. 16.0 years, p = 0.019), a higher baseline level of control according to the ACT (median 17.0 vs. 10.0, p = 0.009), and better quality of life per the AQLQ (median 143.5 vs. 113.0, p = 0.020). No statistically significant intergroup differences were identified for baseline peripheral blood eosinophil count, fractional exhaled nitric oxide (FeNO), total IgE, or pulmonary function parameters. In the overall cohort (n=45), significant improvements in asthma control, quality of life, FEV₁ values, and a reduction in FeNO were observed after 4-6 months of therapy (p 0.05 for all). No adverse events were registered.
CONCLUSIONS Shorter disease duration and better baseline symptom control were identified as predictors of rapid achievement of clinical remission to benralizumab therapy in patients with severe eosinophilic asthma, whereas T2-inflammatory markers did not demonstrate clinical significance. These findings may contribute to optimizing patient selection for anti-IL-5Rα therapy.