Effectiveness of Benralizumab in Patients with Severe Asthma Previously Treated with Mepolizumab in The United Kingdom; a Bpap Study Post-Hoc Analysis
No Thumbnail Available
Authors
Jackson D.J.
Burhan H.
Pfeffer P.E.
Clifton I.J.
Faruqi S.
Nanzer A.M.
Dhariwal J.
Morris T.
Lupton C.
Watt M.
Contact
Check for full-text access
Issue Date
2024
Type
Conference Proceedings
Language
Keywords
Alternative Title
Abstract
Introduction and Objectives Benralizumab is indicated as an add-on maintenance treatment in adult patients with severe eosinophilic asthma (SEA) that is inadequately controlled despite high-dose inhaled corticosteroids plus long-acting beta- agonists. Previous publications have shown effectiveness of benralizumab following failure on an anti-IL-5 biologic. We report results here from the Benralizumab Patient Access Programme (BPAP) study describing benralizumab effectiveness in patients switching from mepolizumab. Methods The BPAP study was a multi-centre, retrospective study of patients with SEA from eight UK centres. Data were collected May 2019 - October 2021 from the medical records of patients receiving their first benralizumab dose between April 2018 and November 2019. This analysis was limited to patients switching to benralizumab from mepolizumab. Outcomes were assessed using descriptive statistics during baseline (12 months prior to benralizumab initiation), index (benralizumab initiation), 1- and 2-years post-benralizumab initiation in patients remaining on treatment. Results 92 patients were included in this subgroup analysis: 88% (81/92) were female; 57% (50/88) had a BMI >=30; mean (SD) age at asthma onset was 34.7 (18.4) years (n=41); 50% (46/92) of patients had atopic asthma. The most common reason for mepolizumab discontinuation was lack of efficacy (85%, 78/92). At baseline, the median (IQR) FeNO count was 80.0 (56.0-120.0) ppb. The median (IQR) peak EOS count during baseline was 400.0 (200.0-700.0) cells/mcL, and median (IQR) EOS at index was 100 (IQR 0.0 to 200.0). Sixty-nine (76%) patients remained on benralizumab at 2 years. The mean (95%CI) annualised exacerbation rate (AER) was reduced by 69% from 4.8 (4.0-5.6) at baseline to 1.5 (1.1-1.9) exacerbations/patient/year at 2 years; 19% (13/69) of patients were exacerbation-free. At baseline, 68% (63/92) of patients were on maintenance oral corticosteroids (mOCS) for asthma; of these, 43% (19/44) were mOCS-free at 2 years. Key outcomes are summarised in table 1. Conclusions Improvement in all clinical measures - including exacerbations, mOCS use, asthma control and health-related quality of life - were observed 2 years post-benralizumab treatment in patients switching from mepolizumab, suggesting more robust targeting of the IL-5 axis may be effective. Results were consistent with international reports, despite higher baseline severity. (Table Presented).
Description
Citation
Publisher
License
Journal
Thorax