Reduction of oral corticosteroids in patients with severe eosinophilic asthma treated with Benralizumab: could it represent a marker of treatment efficacy?

ABSTRACT

Introduction: Subjects with severe Th2-high endotype usually respond to oral corticosteroids (OCS). However, they often require high dosages with incremental side effects and health-care costs. The advent of biological therapies provides an effective strategy to improve asthma control, as well as reduce OCS use. Various molecules have been developed, each targeting different pathways. We analyzed the two anti-IL-5 strategies, benralizumab and mepolizumab, based on pivotal trials (RCTs), mechanisms of action and their possible role on the steroid-sparing effect.

Areas covered: This review analyzes the data from the benralizumab and mepolizumab RCTs, focusing on the advantages of each drug on clinical efficacy and the steroid-sparing effect.

Expert opinion: Benralizumab may represent a promising therapeutic option in the treatment of eosinophilic asthma, due to its mechanism of action, which rapidly allows a reduction in the eosinophils’ number, and a greater steroid-sparing effect.

KEYWORDS:

• Oral corticosteroids
• side effects
• eosinophils
• randomized clinical trials
• severe asthma

Declaration of interest

F Menzella participated in contracted research and clinical trials for Novartis and Sanofi, and has received lecture fees and advisory board from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Mundipharma and Novartis. M Latorre participated in contracted research for Menarini, and has received advisory board fees from AstraZeneca. E Heffler participated in advisory board for GlaxoSmithKline, Teva, AstraZeneca, Sanofi-Genzyme and Nestlè Purina. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.