Rapid Effect of Benralizumab for Hypereosinophilia in a Case of Severe Asthma with Eosinophilic Chronic Rhinosinusitis

Tsurumaki, Hiroaki; Matsuyama, Toshiyuki; Ezawa, Kazuhiro; Koga, Yasuhiko; Yatomi, Masakiyo; Aoki‐Saito, Haruka; Chikamatsu, Kazuaki; Hisada, Takeshi

doi:10.3390/medicina55070336

Cited by 16 publications

(11 citation statements)

References 18 publications

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“…Similar therapeutic effects were described in some case reports recently published by us and other authors, showing that benralizumab decreased the size of nasal polyps visualized by rhinoscopy and eliminated the ethmoid sinus shadows detected by CT scan. 34,36 Conversely, according to the results of a recent phase 2 randomized controlled trial, no significant difference was detected between treatments with benralizumab and placebo with regard to endoscopic nasal polyp score in patients with eosinophilic chronic rhinosinusitis, though this outcome measure improved in many enrolled subjects. 37 However, the duration of this study, lasting only 12 weeks, was too short in order to obtain a convincing evidence about benralizumab inefficacy.…”

Section: Discussionmentioning

confidence: 99%

Real-life effects of benralizumab on allergic chronic rhinosinusitis and nasal polyposis associated with severe asthma

Lombardo

Pelaia

Ciriolo

et al. 2020

Int J Immunopathol Pharmacol

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The aim of this study has been to evaluate the efficacy of the IL-5 receptor blocker benralizumab on chronic rhinosinusitis with nasal polyposis (CRSwNP), associated with severe eosinophilic allergic asthma. Ten patients with severe eosinophilic allergic asthma and CRSwNP were enrolled. Sino-nasal outcome test (SNOT-22), numerical rating scale (NRS), endoscopic nasal polyp score, Lund Mackey CT (computed tomography) score, and blood eosinophil count were measured at baseline and after 24 weeks of treatment with benralizumab. All the above clinical, endoscopic, imaging, and hematological parameters significantly improved after 24 weeks of treatment with benralizumab. In particular, SNOT-22 decreased from 61.10 ± 17.20 to 26.30 ± 19.74 ( P < 0.001), NRS decreased from 7.20 ± 1.55 to 3.40 ± 2.22 ( P < 0.001), the endoscopic polyp nasal score decreased from 4.20 ± 1.32 to 2.50 ± 1.78 ( P < 0.001), the Lund-Mackay CT score decreased from 16.60 ± 5.50 to 6.90 ± 5.99 ( P < 0.001), and blood eosinophil count decreased from 807.3 ± 271.1 cells/μL to 0 cells/μL ( P < 0.0001). These results strongly suggest that benralizumab exerted a very effective therapeutic action on CRSwNP associated with severe asthma, thus improving nasal symptoms and decreasing polyp size.

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Section: Discussionmentioning

confidence: 99%

Real-life effects of benralizumab on allergic chronic rhinosinusitis and nasal polyposis associated with severe asthma

Lombardo

Pelaia

Ciriolo

et al. 2020

Int J Immunopathol Pharmacol

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“…The treatment of refractory CRS is intensively debated in the literature, especially since biological drugs have shown excellent results in the treatment of asthma. While several RCTs have highlighted the efficacy of mAbs in CRSwNP [9][10][11][12] , observational studies evaluating the response to biological treatments in real-life are limited [26][27][28][29][30] .…”

Section: Discussionmentioning

confidence: 99%

Effects of biological therapies on chronic rhinosinusitis in severe asthmatic patients

Bandi

Gallo

Preti

et al. 2020

Acta Otorhinolaryngol Ital

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Objective. The introduction of monoclonal antibody (mAb) therapies represents a promising treatment for refractory chronic rhinosinusitis (CRS). We assessed the effects of selected mAbs (omalizumab, mepolizumab, benralizumab) on CRS in severe asthmatic patients in a real-life setting. Methods. A prospective observational study on severe asthmatic patients, treated with 3 different mAb (omalizumab, mepolizumab, benralizumab), and comorbid CRS was conducted. All patients were followed for 52 weeks. The degree of nasal control, SinoNasal Outcome Test (SNOT) 22, Nasal Polyp Score (NPS), Lund Kennedy Score (LKS) were collected at baseline and at 52-week. Results. 40 patients (33 with nasal polyps) were studied. 33 patients (82.5%) had uncontrolled nasal disease at baseline, and 15 (37.5%) were uncontrolled after 52 weeks. Significant improvement was observed for SNOT 22 (P < 0.001), SNOT 1-12 (P < 0.001) and degree of nasal control (P < 0.001). Differences in NPS (P = 0.130) and LKS (P = 0.124) were not significant. Net change in the above-mentioned parameters among the three treatment groups was not significantly different. Conclusions. The study shows an improvement of nasal symptoms after 52 weeks of mAb treatment, which was not associated with significant improvement of endoscopic findings. Larger studies are needed to assess the real-life efficacy of mAbs in CRS.

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“…This group, who failed one particular biologic, may be worth researching in future studies. Successful reduction of nasal polyps has been reported in a few cases in asthma patients treated with benralizumab [31,32] and two trials are currently ongoing to further evaluate the efficacy of benralizumab in nasal polyposis [33,34]. Dupilumab is the newest biologic agent in use for the treatment of severe asthma.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Biologic Agents in Chronic Urticaria, Asthma and Atopic Dermatitis – A Real-life Experience

Abuzakouk

Ghorab

Wahla

et al. 2020

TORMJ

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Introduction: Several biologic agents have been approved for the treatment of asthma, chronic urticaria and atopic dermatitis. These therapeutic agents are especially useful for patients with severe or refractory symptoms. We present the real-life experience of four of the commonly used biologic agents in the United Arab Emirates. Methods: In this retrospective observational study, we reviewed the demographic, clinical, laboratory and treatment parameters for all patients treated with biologic agents. Results: 270 patients received biologics at our centre between May 2015 and December 2019 with a median age of 36.5 years. Omalizumab was the most prescribed agent (n=183, 67.8%) followed by dupilumab (n=54, 20%), benralizumab (n=22, 8.1%) and mepolizumab (n=11, 4.1%). Urticaria was the commonest treatment indication (n=148, 55%) followed by asthma (n=105, 39%) and atopic dermatitis (n=13, 5%). All chronic urticaria patients were treated with omalizumab and showed improvement in the mean urticaria control test score from 6.7±4.47 to 12.02±4.17, with a p-value of 0.001. Dupilumab was found to be the most commonly prescribed drug for asthma (37%), followed by omalizumab (32%), benralizumab (21%) and mepolizumab (10%). The mean Asthma control test score for all asthmatics combined increased from 17.06 ± 5.4 to 19.44 ± 5.6, with p-value 0.0012 with treatment; FeNO reduced from 60.02 ± 45.74 to 29.11 ± 27.92, with p-value 0.001 and mean FEV1 improved from 2.38L ± 0.8 to 2.67L ± 0.78, with p-value 0.045. Only 4 patients in the entire cohort reported adverse events. Conclusion: Our study demonstrated that biological agents are a safe and effective treatment for atopic asthma, chronic urticaria and atopic dermatitis.

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Rapid Effect of Benralizumab for Hypereosinophilia in a Case of Severe Asthma with Eosinophilic Chronic Rhinosinusitis

Cited by 16 publications

References 18 publications

Real-life effects of benralizumab on allergic chronic rhinosinusitis and nasal polyposis associated with severe asthma

Real-life effects of benralizumab on allergic chronic rhinosinusitis and nasal polyposis associated with severe asthma

Effects of biological therapies on chronic rhinosinusitis in severe asthmatic patients

Efficacy and Safety of Biologic Agents in Chronic Urticaria, Asthma and Atopic Dermatitis – A Real-life Experience

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