Benralizumab Effective for Eosinophilic Asthma and COPD Exacerbations

On Tuesday, December 10, 2024, a study published in The Lancet Respiratory Medicine revealed that benralizumab may be effective in treating acute exacerbations of asthma and chronic obstructive pulmonary disease (COPD) associated with high eosinophil counts. This research was led by Sanjay Ramakrishnan, M.B.B.S., at the University of Western Australia in Perth. The study focused on patients experiencing exacerbations of asthma or COPD who had blood eosinophil counts of 300 cells/µL or higher.

Participants were divided into three groups for the trial. The first group, consisting of 52 patients, received a combination of 30 mg of prednisolone daily for five days alongside a single 100 mg subcutaneous injection of benralizumab (referred to as the BENRA plus PRED group). The second group included 53 patients who were given placebo tablets for five days in addition to a single 100 mg benralizumab injection (the BENRA group). The third group, also consisting of 53 patients, received 30 mg of prednisolone daily for five days along with a placebo subcutaneous injection (the PRED group).

The study's primary objectives were to assess the rate of treatment failures over a period of 90 days and to evaluate symptoms using a visual analog scale (VAS) on the 28th day. The results indicated that treatment failures were significantly lower in the pooled BENRA groups compared to the PRED group, with incidences occurring in 45 percent and 74 percent of patients respectively, resulting in an odds ratio of 0.26. Furthermore, the pooled BENRA groups showed a mean VAS difference of 49 mm compared to the PRED group after 28 days, indicating better symptom control.

Importantly, the study reported no fatal adverse events, and benralizumab was found to be well-tolerated among participants. These findings suggest that benralizumab could be a viable option for acute treatment in patients with eosinophilic exacerbations of asthma and COPD.

The authors of the study highlighted its significance, stating, "The ABRA [Acute exacerbations treated with BenRAlizumab] study is the first trial to target the eosinophilic treatable trait during exacerbations. This study shows that benralizumab is effective as an acute treatment of eosinophilic exacerbation."

It is noteworthy that several authors involved in the study disclosed connections to biopharmaceutical companies, including AstraZeneca, which is responsible for manufacturing benralizumab and also funded the research.

The study opens up new possibilities for managing acute eosinophilic exacerbations, potentially offering improved outcomes for patients suffering from these respiratory conditions. The results may lead to further exploration of benralizumab's role in acute treatments, paving the way for advancements in therapeutic approaches for asthma and COPD exacerbations driven by eosinophilic inflammation.