A real-life study of patients with severe asthma and EGPA treated with anti-IL5R

Background Anti-interleukin-5 (IL5) treatment has been shown to reduce flares and oral corticosteroid (OCS) dosage in patients with eosinophilic granulomatosis with polyangiitis (EGPA) and was recently licensed for treatment of EGPA. In real-life patients in our severe asthma center, patients with severe asthma and EGPA were also treated with anti-IL5R according to asthma indication.

Aim The aim of this study was to describe use and outcomes of patients with severe asthma and EGPA treated with the anti-interleukin-5 receptor (IL5R) antibody benralizumab in a real-life cohort.

Methods We analyzed all patients from our center (LMU Munich) included in the prospective GAN registry who had been diagnosed with severe asthma and EGPA, were on continuous OCS therapy and were started on benralizumab. We compared outcome parameters before and 12 months after the initiation of benralizumab, including OCS dosage, flares, lung function and biomarkers.

Results We identified 16 patients, 12 female, 4 male who had a diagnosis of EGPA and were treated with benralizumab. Pulmonary, ENT as well as neurological and cardiac manifestations were most common. 22% of patients had detectable antineutrophil cytoplasmic antibodies. All patients were on oral corticosteroid (OCS) therapy and 7 required additional immunosuppressive therapy (4 patients MTX, 2 patients azathioprine, 1 patient cyclosporine A). After 12 months of benralizumab there was a significant reduction in OCS dosage and EGPA flares. Further, we found significant reduction of blood eosinophil count (BEC), but no difference on fraction of exhaled NO (FeNO). There was no difference in FEV1% and FVC%, but a significant increase in MEF25% on lung function testing.

Conclusion In this real-life cohort of patients with severe asthma and EGPA, benralizumab use led to improvement in the number of EGPA flares and had a significant OCS sparing effect.

Publikationsverlauf

Artikel online veröffentlicht:
09. März 2023