Overcoming Barriers to Remission in Severe Eosinophilic Asthma: Two-Year Real-World Data With Benralizumab

IF 6.3 2区医学 Q1 ALLERGY

Clinical and Experimental Allergy Pub Date : 2024-07-31 DOI:10.1111/cea.14544

David J. Jackson, Hassan Burhan, Hitasha Rupani, Paul E. Pfeffer, Ian J. Clifton, Shoaib Faruqi, Jaideep Dhariwal, Pujan Patel, Tamsin Morris, Joseph Lipworth, Michael Watt, Charlotte Lupton, Sabada Dube, Joe Hickey, Alexandra M. Nanzer

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Abstract

Background

Benralizumab has been reported to lead to clinical remission of severe eosinophilic asthma (SEA) at 1 year in some patients. However, whether this is maintained over a longer term remains unclear. Additionally, the impact of pulmonary and extrapulmonary comorbidities on the ability to meet remission is poorly understood.

Methods

Clinical outcomes including remission of SEA with benralizumab at 1 and 2 years were assessed retrospectively in a real-world UK multi-centre severe asthma cohort. The presence of clinically relevant pulmonary and extrapulmonary comorbidities associated with respiratory symptoms was recorded. Analyses to identify factors associated with the ability to meet remission were performed.

Results

In total, 276 patients with SEA treated with benralizumab including 113 patients who had switched from a previous biologic to benralizumab were included. Overall, clinical remission was met in 17% (n = 31/186) and 32% (n = 43/133) of patients at 1 and 2 years, respectively. This increased to 28% at 1 year and 49% at 2 years once patients with pulmonary and/or extrapulmonary comorbidities were excluded. Body mass index (BMI) and maintenance OCS (mOCS) use demonstrated a negative association with clinical remission at 1 (BMI: OR: 0.89, 95% CI: 0.82–0.96, p < 0.01; mOCS: OR: 0.94, 95% CI: 0.89–0.99, p < 0.05) and 2 years (BMI: OR: 0.93, 95% CI: 0.87–0.99, p < 0.05; mOCS: OR: 0.95, 95% CI: 0.89–0.99, p < 0.05).

Conclusions

In this long-term, real-world study, patients with SEA demonstrated the ability to meet and sustain clinical remission when treated with benralizumab. The presence of comorbidities including obesity, which are known to be independently associated with respiratory symptoms, reduced the likelihood of meeting clinical remission.

Abstract Image

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克服严重嗜酸性粒细胞性哮喘缓解的障碍：使用苯拉利珠单抗的两年真实世界数据。

背景：据报道，苯拉利珠单抗可使一些重度嗜酸性粒细胞性哮喘（SEA）患者在一年后临床症状缓解。然而，这种缓解能否维持更长的时间仍不清楚。此外，肺部和肺外合并症对缓解能力的影响也不甚了解：方法：在一个真实世界的英国多中心重症哮喘队列中，对临床结果进行了回顾性评估，包括使用苯拉利珠单抗 1 年和 2 年后 SEA 的缓解情况。记录了与呼吸道症状相关的临床肺部和肺外合并症的存在情况。对与缓解能力相关的因素进行了分析：共纳入了276名接受苯拉利珠单抗治疗的SEA患者，其中包括113名从之前的生物制剂转用苯拉利珠单抗的患者。总体而言，分别有17%（n = 31/186）和32%（n = 43/133）的患者在1年和2年后达到临床缓解。排除肺部和/或肺外合并症患者后，1年和2年临床缓解率分别增至28%和49%。体重指数（BMI）和维持性 OCS（mOCS）的使用与 1 年后的临床缓解呈负相关（BMI：OR：0.89，95% CI：0.82-0.96，P 结论：在这项长期的真实世界研究中，SEA患者在接受苯拉利珠单抗治疗后，能够达到并维持临床缓解。众所周知，肥胖等合并症与呼吸道症状密切相关，而肥胖则降低了达到临床缓解的可能性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Allergy 医学-过敏

CiteScore

10.40

自引率

9.80%

发文量

189

审稿时长

3-8 weeks

期刊介绍： Clinical & Experimental Allergy strikes an excellent balance between clinical and scientific articles and carries regular reviews and editorials written by leading authorities in their field. In response to the increasing number of quality submissions, since 1996 the journals size has increased by over 30%. Clinical & Experimental Allergy is essential reading for allergy practitioners and research scientists with an interest in allergic diseases and mechanisms. Truly international in appeal, Clinical & Experimental Allergy publishes clinical and experimental observations in disease in all fields of medicine in which allergic hypersensitivity plays a part.