Benralizumab Shows Some Sustained Remissions in Severe Eosinophilic Asthma

People with severe eosinophilic asthma (SEA) had sustained remissions with benralizumab reaching up to 2 years in long-term, real-world data.¹

“Long-term real-world data on clinical remission in patients with SEA receiving biologics are lacking. We describe clinical remission over 2 years in patients with SEA receiving benralizumab,” lead investigator Girolamo Pelaia, MD, Full Professor of Respiratory Medicine, Head of the Respiratory Disease Unit Director of the Postgraduate Specialization, School of Respiratory Diseases, Department of Health Sciences University "Magna Graecia" of Catanzaro, and colleagues wrote.¹

Pelaia and colleagues conducted the multinational, retrospective, real-world XALOC-1 program in adults with SEA who received benralizumab for up to 96 weeks. They assessed the percentage of patients meeting the components and composite of clinical remission (no exacerbations, no maintenance oral corticosteroid [mOCS] use, and well-controlled asthma at Weeks 0, 48, and 96. They used multivariable logistic regression analysis to assess associations between key baseline demographics, clinical characteristics, and clinical remission status at Weeks 48 and 96.

The investigators found that of 1070 patients, 0.4%, met the 3-component clinical remission criteria at week 0, 39% met it at week 48, and 31% met it at week 96. Remission occurred in 43% of In biologic-naïve patients at week 48 and 36% at week 96; 32% of biologic-experienced patients achieved remission at week 48 and 23% achieved remission at week 96.¹

Pelaia and colleagues also found that patients with lower maintenance oral corticosteroid (mOCS; odds ratio [OR]; 0.51 [95% CI, 0.34-0.76]), lower body mass index (OR, 0.56 [95% CI, 0.36-0.86]), and higher peak eosinophil count (OR, 1.68 [95% CI, 1.05-2.69]) at baseline were positively associated with meeting criteria for clinical remission at Week 96.¹

“Clinical remission is a realistic goal, sustainable up to 2 years in around one-third of patients with SEA receiving benralizumab. Remission was more likely in patients with lower baseline disease burden, suggesting that further research is warranted regarding whether earlier initiation of a biologic may be beneficial,” Pelaia and colleagues concluded.²

ZEPHYR-5, another real-world benralizumab program, recently reported data at March’s 2025 American Academy of Allergy, Asthma, & Immunology (AAAAI) annual meeting in San Diego that found that older adults with severe asthma receiving the therapy experienced meaningful reductions in the rate of asthma exacerbations.²

ZEPHYR-5 included 5611 patients with a mean age of 69.3±10.9 years. Benralizumab led to a 43.5% reduction in the annual asthma exacerbation rate from baseline to follow-up in older adults (3.8±2.0 to 2.2±2.2 exacerbations per year; P< .001). Moreover, the proportion of patients with ≥ 4 exacerbations were reduced by 50.5%.²

“It was very important for me to know that in this particular age group, this drug is also very effective… No matter how many exacerbations they had to begin with, whether they had 2 exacerbations, 3 exacerbations, or 4 exacerbations… the beneficial effect of [the] drug was seen across the spectrum,” lead investigator Muhammad Adrish, MD, from Baylor College of Medicine, told HCPLive during the meeting.

REFERENCES

Pelaia G, Jackson DJ, Nair P, et al. XALOC-1: Clinical remission over 2-years with benralizumab in severe eosinophilic asthma. Chest. Published online April 19, 2025. DOI: 10.1016/j.chest.2025.04.011

Adrish, M. Reduction in Asthma Exacerbations Following Initiation of Benralizumab Among Medicare Beneficiaries: Results from the ZEPHYR-5 Study Adrish. Abstract 938. Presented at AAAAI 2025 on March 3 at 1:10 pm