Real-life rapidity of benralizumab effects in patients with severe allergic eosinophilic asthma: Assessment of blood eosinophils, symptom control, lung function and oral corticosteroid intake after the first drug dose

Pelaia, Corrado; Busceti, Maria Teresa; Vatrella, Alessandro; Rago, Giuseppe; Crimi, Claudia; Terracciano, Rosa; Pelaia, Girolamo

doi:10.1016/j.pupt.2019.101830

Cited by 47 publications

(45 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Taken together, the findings of our present study indicate that benralizumab had a very positive impact on nasal polyps in atopic patients with severe eosinophilic asthma. Since we have previously shown in these same subjects that benralizumab rapidly and effectively impacted on clinical control of their severe asthma, as well as on lung function and OCS intake, 44 it appears that the add-on treatment with this biologic drug can induce an overall improvement in the quality of life of atopic patients with severe asthma and coexistent CRSwNP. On the other hand, in severe asthmatics nasal polyps represent a comorbid condition which can be considered as a very reliable predictor of a positive therapeutic response to benralizumab.…”

Section: Discussionmentioning

confidence: 81%

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

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 81%

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

Self Cite

View full text Add to dashboard Cite

show abstract

“…Of the 1757 potentially relevant records identified in the initial search, 59 real-world studies were deemed eligible for a qualitative analysis. Six studies were carried out on benralizumab [34][35][36][37][38][39], 1 on dupilumab [40], 18 on mepolizumab [41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58], 27 on omalizumab [18,, and 3 on reslizumab [85][86][87]. Four studies investigated different mAbs in the same report [88][89][90][91].…”

Section: Study Characteristicsmentioning

confidence: 99%

Oral Corticosteroids Dependence and Biologic Drugs in Severe Asthma: Myths or Facts? A Systematic Review of Real-World Evidence

Calzetta

Aiello

Frizzelli

et al. 2021

IJMS

View full text Add to dashboard Cite

Airway inflammation represents an important characteristic in asthma, modulating airflow limitation and symptom control, and triggering the risk of asthma exacerbation. Thus, although corticosteroids represent the cornerstone for the treatment of asthma, severe patients may be dependent on oral corticosteroids (OCSs). Fortunately, the current humanised monoclonal antibodies (mAbs) benralizumab, dupilumab, mepolizumab, omalizumab, and reslizumab have been proven to induce an OCS-sparing effect in randomized controlled trials (RCTs), thus overcoming the problem of OCS dependence in severe asthma. Nevertheless, a large discrepancy has been recognized between selected patients enrolled in RCTs and non-selected asthmatic populations in real-world settings. It is not possible to exclude that the OCS-sparing effect of mAbs resulting from the RCTs could be different than the real effect resulting in clinical practice. Therefore, we performed a systematic review and correlation analysis to assess whether mAbs are effective in eliciting an OCS-sparing effect and overcoming the OCS dependence in severe asthmatic patients in real-world settings. Overall, real-world studies support the evidence that OCS dependence is a real condition that, however, can be found only in a small number of really severe asthmatic patients. In most patients, the dependence on OCS can be related to modifying factors that, when adequately modulated, may lead to a significant reduction or suspension of OCS maintenance. Conversely, in severe asthmatics in whom OCS resistance is proved by a high daily dose intake, mAbs allow reversion of the OCS dependence, leading to the suspension of OCS therapy in most patients or >50% reduction in the daily OCS dose.

show abstract

“…All these findings, regarding clinical and functional outcomes, have been corroborated, and even extended and amplified by recent real-life experiences. The latter are providing convincing evidence referring to the safety and efficacy of benralizumab, detected in both atopic and nonatopic subjects with eosinophilic uncontrolled asthma, with regard to relevant improvements in asthma exacerbations, OCS consumption, symptom control, airflow limitation, lung hyperinflation, and nasal polyposis (129)(130)(131)(132).…”

Section: Licensed Biological Therapies Of Severe Asthmamentioning

confidence: 87%

Molecular Targets for Biological Therapies of Severe Asthma

et al. 2020

Self Cite

View full text Add to dashboard Cite

Asthma is a heterogeneous respiratory disease characterized by usually reversible bronchial obstruction, which is clinically expressed by different phenotypes driven by complex pathobiological mechanisms (endotypes). Within this context, during the last years several molecular effectors and signalling pathways have emerged as suitable targets for biological therapies of severe asthma, refractory to standard treatments. Indeed, various therapeutic antibodies currently allow to intercept at different levels the chain of pathogenic events leading to type 2 (T2) airway inflammation. In addition to pro-allergic immunoglobulin E (IgE), that chronologically represents the first molecule against which an anti-asthma monoclonal antibody (omalizumab) was developed, today other targets are successfully exploited by biological treatments of severe asthma. In particular, pro-eosinophilic interleukin 5 (IL-5) can be targeted by mepolizumab or reslizumab, whereas benralizumab is a selective blocker of IL-5 receptor. Moreover, dupilumab behaves as a dual receptor antagonist of pleiotropic interleukins 4 (IL-4) and 13 (IL-13). Besides these drugs that are already available in medical practice, other biologics are under clinical development such as those targeting innate cytokines, also including the alarmin thymic stromal lymphopoietin (TSLP), which plays a key role in the pathogenesis of type 2 asthma. Therefore, ongoing and future biological therapies are significantly changing the global scenario of severe asthma management. These new therapeutic options make it possible to implement phenotype/endotype-specific treatments, that are delineating personalized approaches precisely addressing the individual traits of asthma pathobiology. Such tailored strategies are thus allowing to successfully target the immune-inflammatory responses underlying uncontrolled T2-high asthma.

show abstract

Real-life rapidity of benralizumab effects in patients with severe allergic eosinophilic asthma: Assessment of blood eosinophils, symptom control, lung function and oral corticosteroid intake after the first drug dose

Cited by 47 publications

References 50 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

Oral Corticosteroids Dependence and Biologic Drugs in Severe Asthma: Myths or Facts? A Systematic Review of Real-World Evidence

Molecular Targets for Biological Therapies of Severe Asthma

Contact Info

Product

Resources

About