Real-World Experience with Benralizumab in Patients with Severe Eosinophilic Asthma: A Case Series

Figures & data

Table 1 Baseline Patient Characteristics

Case	1	2	3	4	5	6	7	8	9	10
Sex	F	M	M	M	F	F	F	F	F	F
Age at visit, yrs	59	70	63	34	26	19	47	47	57	54
Phenotype (allergic/non-allergic)	Non allergic	Non allergic	Allergic - mixed phenotype with eosinophils and neutrophils	Non allergic	Non allergic	Non allergic	Non allergic	Allergic	Non allergic	Non allergic
Age at onset, yrs	48		20	29	16	14		16	45	44
Smoking status	Never smoker	Ex-smoker (8 packs/yr)	Ex-smoker (25 packs/yr)	Never smoker		Never smoker	Never smoker	Never smoker	Never smoker	Ex-smoker
Comorbidities	Chronic rhinitis	Hiatal hernia, GER, T2DM, hypercholesterolemia, prostatic hypertrophy and recurrent NP	Chronic rhinosinusitis: NP (score 3) was found with bilateral hypertrophy of inferior turbinates	Congenital deficit of GH, idiopathic urticaria, chronic rhinosinusitis	Recurrent NP	Marked hypertrophy of middle and inferior turbinates	Hiatal hernia with GER, previous eosinophilic pneumonia and maxillary sinusitis w/out NP; bronchial asthma	NP		Rhinosinusitis. NP
Exacerbations in the last 12 mos	3	4	12–15 per yr	4		in Dec 2017; none from January 2018 to October 2019	2	6–8/year (during the prior 7 yrs)	Yes	≥5, in the past 2 years
Hospitalization/ER access in the last 12 mos	None		1 ER access in Dec 2018	None		Hospital. in Sept. 2017 for acute respiratory failure secondary to bronchial asthma exacerbation and severe hyper eosinophilia	None	1 hosp/yr during the prior 7 yrs	None	2 ER admissions in the past 2 yrs
Corticosteroids (Yes/No)	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Previous mAb	No	No	Omalizumab therapy from 2012 to 2015, discontinued for poor clinical response; mepolizumab 2017–2019, discontinued because of exacerbations	No	No	Mepolizumab from January 2018 to May 2018 with improvement of asthma symptoms but no nasal symptom response	No	Omalizumab in 2014 which led to reduction of OCS therapy (average 12.5–25 mg), but not of exacerbations, nor asthma control	Omalizumab from 2016 to 2018, discontinued for poor clinical response	No
FEV1, %	86	44	28	25	70		64.8	40	37	80
FEV1 post, %		>14	34	32.4
FEV1/FVC, %		45	59	55			63.8	57	41.4	71
FeNO, ppb		112	88	8
ACT/ACQ	18	14	13/2.5	11/2.25	14		11/3.2	8	15	16/2.25
Eos count, cells/mmc	850	352	497	305	1200	530	1300	620	577	750
IgE		139			126	128			130	120
Atopy (Yes/No)	No	No	Yes	No	No	No	No	Yes	Yes	No
NP (Yes/No)	Yes	Yes	Yes	No	Yes	No	No	Yes	No	Yes

Note: Blank cells represent data not available.

Abbreviations: F, female; M, male; yrs, years; GER, gastroesophageal reflux; T2DM, type-2 diabetes mellitus; NP, nasal polyposis; GH, growth hormone; mos, months; ER, emergency room; mAb, monoclonal antibody; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; FeNO, fractional exhaled nitric oxide; ppb, parts per billion; ACT, Asthma Control Test; ACQ, Asthma Control Questionnaire; Eos, eosinophils; IgE, immunoglobulin E.

Figure 1 Values of eosinophil count (A), ACT (B) and FEV1 (C) recorded in each patient at baseline and during benralizumab treatment.