Early Asthma Control Improvement with Benralizumab: 8-Week Integrated Analysis from the Real-World XALOC-2 Study

Rationale Benralizumab depletes blood eosinophils (bEOS) within 24 hours, which translates in clinical trials to early benefits in patients with severe eosinophilic asthma (SEA). Our aim was to understand the real-world effectiveness of benralizumab on asthma control from 1 week after treatment initiation.

Methods XALOC-2 is a prospective real-world study of benralizumab in patients with SEA in Canada, Belgium, Germany and Switzerland. This integrated interim analysis assessed Asthma Control Questionnaire (ACQ-6) score change from baseline to Week 8, stratified by baseline characteristics.

Results 413 patients were included, 40% were male, 34% with CRSwNP, 66% using maintenance OCS. Mean (SD) age 56 (15) years, age of first asthma diagnosis 37 (20) years, bEOS 645 (542) cells/µL and 3.0 (3.4) exacerbations in the past year. There was a least squares (LS) mean reduction in ACQ-6 over the first 8 weeks of benralizumab treatment, from –0.7 (95% CI –0.8, –0.6) at Week 1 to –1.2 (95% CI –1.3, –1.1) at Week 8. An improvement of≥0.5 (the minimally clinically important difference [MCID]) was seen in 58% of patients (220/378) at Week 1. At Week 8, 70% (263/376) showed an improvement of≥1xMCID, and 55% (208/376) of≥2xMCID. ACQ-6 improvements were more pronounced in patients with CRSwNP (LS mean change –1.5 [95% CI –1.7, –1.3]) and with bEOS≥500 cells/µL (LS mean change –1.4 [95 CI –1.6, –1.2]) at Week 8.

Conclusions Targeting eosinophilic inflammation in SEA with benralizumab is associated with an early response beginning at Week 1 in asthma symptom control across subgroups.

Publication History

Article published online:
09 March 2023