The effect of benralizumab on inflammation in severe asthma: a real-life analysis

Background: Benralizumab is a monoclonal antibody treatment for severe eosinophilic asthma (SEA). Few studies investigated its role in airway inflammation and its correlation with lung function. Objectives: The aim of the present study is to assess its effect after 1 year of treatment, focusing on a...

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Main Authors: Dina Visca, Francesco Ardesi, Martina Zappa, Sarah Grossi, Patrizia Pignatti, Marco Vanetti, Laura Pini, Giovanni Sotgiu, Rosella Centis, Giovanni Battista Migliori, Antonio Spanevello
Format: Article
Language:English
Published: SAGE Publishing 2024-12-01
Series:Therapeutic Advances in Respiratory Disease
Online Access:https://doi.org/10.1177/17534666241304685
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author Dina Visca
Francesco Ardesi
Martina Zappa
Sarah Grossi
Patrizia Pignatti
Marco Vanetti
Laura Pini
Giovanni Sotgiu
Rosella Centis
Giovanni Battista Migliori
Antonio Spanevello
author_facet Dina Visca
Francesco Ardesi
Martina Zappa
Sarah Grossi
Patrizia Pignatti
Marco Vanetti
Laura Pini
Giovanni Sotgiu
Rosella Centis
Giovanni Battista Migliori
Antonio Spanevello
author_sort Dina Visca
collection DOAJ
description Background: Benralizumab is a monoclonal antibody treatment for severe eosinophilic asthma (SEA). Few studies investigated its role in airway inflammation and its correlation with lung function. Objectives: The aim of the present study is to assess its effect after 1 year of treatment, focusing on airway inflammation. Design: This is a retrospective observational study, in an Italian tertiary reference centre specialised in diagnosis and management of severe asthma patients. Methods: We conducted a monocentric retrospective study including SEA patients treated with benralizumab for 1 year. Clinical, functional and inflammatory data were collected at baseline, 6 (T6) and 12 (T12) months. Results: Twenty-two SEA patients on benralizumab were included. We observed a reduction in exacerbations rate and systemic steroid treatment ( p  < 0.0001) as well as an improvement in asthma control ( p  < 0.0001), health-related quality of life ( p  = 0.017) and lung function pre-BD FEV1 (L) ( p  = 0.02) and percentage ( p  = 0.004) and post-BD FEV1 (L) ( p  = 0.01) and percentage ( p  = 0.003) from baseline to T6 and T12. A reduction in sputum eosinophil percentage was observed at T6 and T12 ( p  < 0.005). We found a positive correlation between the variation of sputum eosinophils percentage and FEV1 (L) at T12 (rho = −0.79, p  = 0.04). Moreover, the improvement of FEF 25%–75% from baseline to 6 (rho = −0.53, p  = 0.03) and 12 (rho = −0.62, p  = 0.01) months negatively correlated with the duration of asthma disease. In our cohort 12/22 patients were super-responders at T6 and 15/22 at T12. Furthermore, clinical remission was reached by 12/22, and all of them obtained blood and sputum eosinophils counts normalisation. Conclusion: Our data confirm that it is a rapid and effective treatment for SEA acting on clinical, functional, systemic and airway inflammatory outcomes. Our results highlight the role of induced sputum as a promising non-invasive technique to investigate pathophysiologic mechanisms in severe asthma treated with biologics. Finally, a negative correlation between small airway improvement and the duration of asthma may suggest that a prompt referral to asthma centres may delay lung function worsening. Additional studies are needed to investigate more in-depth the role of induced sputum in the management of asthma, response to treatment and remission.
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spelling doaj-art-bf161a6fe37c4db7b7799d1a9d2d5c782025-08-20T01:58:28ZengSAGE PublishingTherapeutic Advances in Respiratory Disease1753-46662024-12-011810.1177/17534666241304685The effect of benralizumab on inflammation in severe asthma: a real-life analysisDina ViscaFrancesco ArdesiMartina ZappaSarah GrossiPatrizia PignattiMarco VanettiLaura PiniGiovanni SotgiuRosella CentisGiovanni Battista MiglioriAntonio SpanevelloBackground: Benralizumab is a monoclonal antibody treatment for severe eosinophilic asthma (SEA). Few studies investigated its role in airway inflammation and its correlation with lung function. Objectives: The aim of the present study is to assess its effect after 1 year of treatment, focusing on airway inflammation. Design: This is a retrospective observational study, in an Italian tertiary reference centre specialised in diagnosis and management of severe asthma patients. Methods: We conducted a monocentric retrospective study including SEA patients treated with benralizumab for 1 year. Clinical, functional and inflammatory data were collected at baseline, 6 (T6) and 12 (T12) months. Results: Twenty-two SEA patients on benralizumab were included. We observed a reduction in exacerbations rate and systemic steroid treatment ( p  < 0.0001) as well as an improvement in asthma control ( p  < 0.0001), health-related quality of life ( p  = 0.017) and lung function pre-BD FEV1 (L) ( p  = 0.02) and percentage ( p  = 0.004) and post-BD FEV1 (L) ( p  = 0.01) and percentage ( p  = 0.003) from baseline to T6 and T12. A reduction in sputum eosinophil percentage was observed at T6 and T12 ( p  < 0.005). We found a positive correlation between the variation of sputum eosinophils percentage and FEV1 (L) at T12 (rho = −0.79, p  = 0.04). Moreover, the improvement of FEF 25%–75% from baseline to 6 (rho = −0.53, p  = 0.03) and 12 (rho = −0.62, p  = 0.01) months negatively correlated with the duration of asthma disease. In our cohort 12/22 patients were super-responders at T6 and 15/22 at T12. Furthermore, clinical remission was reached by 12/22, and all of them obtained blood and sputum eosinophils counts normalisation. Conclusion: Our data confirm that it is a rapid and effective treatment for SEA acting on clinical, functional, systemic and airway inflammatory outcomes. Our results highlight the role of induced sputum as a promising non-invasive technique to investigate pathophysiologic mechanisms in severe asthma treated with biologics. Finally, a negative correlation between small airway improvement and the duration of asthma may suggest that a prompt referral to asthma centres may delay lung function worsening. Additional studies are needed to investigate more in-depth the role of induced sputum in the management of asthma, response to treatment and remission.https://doi.org/10.1177/17534666241304685
spellingShingle Dina Visca
Francesco Ardesi
Martina Zappa
Sarah Grossi
Patrizia Pignatti
Marco Vanetti
Laura Pini
Giovanni Sotgiu
Rosella Centis
Giovanni Battista Migliori
Antonio Spanevello
The effect of benralizumab on inflammation in severe asthma: a real-life analysis
Therapeutic Advances in Respiratory Disease
title The effect of benralizumab on inflammation in severe asthma: a real-life analysis
title_full The effect of benralizumab on inflammation in severe asthma: a real-life analysis
title_fullStr The effect of benralizumab on inflammation in severe asthma: a real-life analysis
title_full_unstemmed The effect of benralizumab on inflammation in severe asthma: a real-life analysis
title_short The effect of benralizumab on inflammation in severe asthma: a real-life analysis
title_sort effect of benralizumab on inflammation in severe asthma a real life analysis
url https://doi.org/10.1177/17534666241304685
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