Benralizumab-induced asthma remission: evidence from the real-world imPROve study

Background Biologic treatment may lead to remission in severe asthma. However, the potential for remission with biologics in real-world populations is poorly understood.

Aim To assess a range of responses to benralizumab, including clinical remission, in patients with severe eosinophilic asthma (SEA) in the real world.

Methods This is an interim analysis of patients with SEA treated with benralizumab in the prospective imPROve Asthma study in Germany. Here, we assessed response/super response/remission in patients with 6- and 12-month follow-up data. Criteria for each were, respectively: exacerbations (≥50% reduction/0 or≥75% reduction/0), maintenance OCS (mOCS) use (≥50% reduction/0/0), FEV₁ (≥100mL improvement/≥500mL improvement/stable [no deterioration of 200mL or more vs baseline]), asthma symptom control (ACQ-6 or ACT≥MCID/ACQ-6 or ACT≥2xMCID or ACQ-6<1, ACT>19/ACT≥20 [or ACQ-6<0.75 assessed separately]).

Results A total of 243 patients were included in the study (baseline: mean age 57 years, mean exacerbation rate 2.6 in the previous 12 months, 58% female, 81% with mOCS). At 6 and 12 months, 169/183 (92%) and 115/124 (93%) achieved response (any criteria), 89/178 (50%) and 69/118 (59%) achieved super response (≥3 criteria). When using ACT≥20 for asthma control, 36/114 (32%) patients met remission criteria after 6 months, and 34/91 (37%) after 12 months of benralizumab treatment. When using ACQ-6<0.75, 16/113 (14%) met remission criteria after 6 months, and 21/83 (25%) after 12 months.

Conclusion In this real-world study, clinically meaningful improvements were achieved by the majority of patients. At least one quarter of the patients achieved clinical remission at 12 months.

Publication History

Article published online:
09 March 2023