Journal of Clinical Medicine (Jun 2023)

Benralizumab Effectiveness in Severe Eosinophilic Asthma with Co-Presence of Bronchiectasis: A Real-World Multicentre Observational Study

  • Raffaele Campisi,
  • Santi Nolasco,
  • Corrado Pelaia,
  • Pietro Impellizzeri,
  • Maria D’Amato,
  • Andrea Portacci,
  • Luisa Ricciardi,
  • Giulia Scioscia,
  • Nunzio Crimi,
  • Nicola Scichilone,
  • Maria Pia Foschino Barbaro,
  • Girolamo Pelaia,
  • Giovanna Elisiana Carpagnano,
  • Alessandro Vatrella,
  • Claudia Crimi

DOI
https://doi.org/10.3390/jcm12123953
Journal volume & issue
Vol. 12, no. 12
p. 3953

Abstract

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Introduction: The co-presence of bronchiectasis (BE) in severe eosinophilic asthma (SEA) is common. Data about the effectiveness of benralizumab in patients with SEA and BE (SEA + BE) are lacking. Aim: The aim of this study was to evaluate the effectiveness of benralizumab and remission rates in patients with SEA compared to SEA + BE, also according to BE severity. Methods: We conducted a multicentre observational study, including patients with SEA who underwent chest high-resolution computed tomography at baseline. The Bronchiectasis Severity Index (BSI) was used to assess BE severity. Clinical and functional characteristics were collected at baseline and after 6 and 12 months of treatment. Results: We included 74 patients with SEA treated with benralizumab, of which 35 (47.2%) showed the co-presence of bronchiectasis (SEA + BE) with a median BSI of 9 (7–11). Overall, benralizumab significantly improved the annual exacerbation rate (p p p p p = 0.0003], and the daily dose of OCS [−5 mg (0 to −12.5) vs. −12.5 mg (−7.5 to −20), p = 0.0112]. Remission (zero exacerbations + zero OCS) was achieved more frequently in the SEA cohort [66.7% vs. 14.3%, OR 0.08 (95% CI 0.03–0.27), p 1% and FEF25–75% were inversely correlated with BSI (r = −0.36, p = 0.0448 and r = −0.41, p = 0.0191, respectively). Conclusions: These data suggest that benralizumab exerts beneficial effects in SEA with or without BE, although the former achieved less OCS sparing and fewer respiratory-function improvements.

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