Benralizumab is likely to be effective against refractory asthma or ear, nose, and throat (ENT) manifestations of eosinophilic granulomatosis with polyangiitis (EGPA), a form of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).
These results are according to an article published in the Annals of the Rheumatic Diseases.
Benralizumab is known to be effective in eosinophilic asthma; however, its role in treating other eosinophil-associated disorders has been largely unexplored. Researchers have initiated investigations into the potential use of this therapy in treating EGPA, but most of these studies are limited to case reports and small case series; sturdier studies involving larger patient populations are currently lacking.
The authors sought to investigate the merits of benralizumab among 68 patients with EGPA on an off-label basis. This retrospective study was conducted at multiple centers. The research team defined the primary endpoint as the rate of complete response (meaning a Birmingham Vasculitis Activity Score of 0) and a prednisone dose of 4 mg or less per day. Partial response, on the other hand, was defined as the same score but with a prednisone dose of 4 mg or more per day.
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Among the 68 patients with EGPA included in the study, the researchers reported that 54 (81%) were prescribed benralizumab for uncontrolled asthma, while 27 (40%) were prescribed the drug for ENT manifestations of EGPA. Most patients (48; 74%) were on long-term glucocorticoids.
The median follow-up time was 23 months. The researchers reported that 33 patients (49%) achieved a complete response, while 24 (36%) achieved a partial response. Ten (15%) did not respond to benralizumab initiation. Benralizumab was effective enough for 23 patients (38%) to discontinue their glucocorticoid therapy.
Among the adverse events reported was vasculitis flares in 7 patients (11%); these were associated with histological evidence of vasculitis, with or without ANCA positivity upon benralizumab initiation.
The researchers concluded that benralizumab may be useful in treating refractory asthma and ENT disease associated with EGPA and could allow for glucocorticoid sparing.
Cottu A, Groh M, Desaintjean C, et al. Benralizumab for eosinophilic granulomatosis with polyangiitis. Ann Rheum Dis. Published online August 7, 2023. doi:10.1136/ard-2023-224624