What Is New in Severe Asthma Research

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Christina E Ciaccio, MD, MSc

Christina E Ciaccio, MD, MSc
Allergist/Immunologist
Assistant Professor of Pediatrics
University of Chicago Medicine
Comer Children’s Hospital
Chicago, Illinois, United States

Oral glucocorticoid–sparing effect of benralizumab in severe asthma
Nair P, Wenzel S, Rabe KF, Bourdin A, Lugogo NL et al, for the ZONDA Trial Investigators. New England Journal of Medicine 2017; 376:2448-2458. DOI:10/1056/NEJMoa1703501

Abstract

Summary

Benralizumab is a monoclonal antibody against the alpha subunit of the IL-5 receptor that has been shown to reduce asthma exacerbations. In this study, investigators sought to determine if it can also be an effective steroid-sparing agent in asthma with eosinophilia (>150/mm3). The primary endpoint of this randomized, placebo controlled trial was percent change in oral corticosteroid use. Patients received either benralizumab 30mg SQ every 4 weeks, every 8 weeks or placebo. Those receiving benralizumab achieved a 75% reduction in oral corticosteroids compared to 25% of those on placebo. Thirty-three percent of patients receiving benralizumab every 4 weeks had a 90% reduction in oral corticosteroid use while 37% of those receiving study drug every 9 weeks had a 90% reduction in oral corticosteroid use. Just over 50% of those in both benralizumab groups were able to stop oral corticosteroids all together. Twenty percent in treatment groups, however, had no reduction in oral corticosteroid use. No significant effect in FEV1 was noted at the end of the trial. Adverse events in this trial were reported in 75% of the treatment group and included nasopharyngitis, worsening asthma, and bronchitis. Twenty-eight patients reported serious adverse events which was predominantly worsening asthma. Benralizumab is another promising agent for the treatment of severe asthma with eosinophilia; however, as with all new asthma treatments accurate phenotyping remains elusive.

 

Last updated: Friday, August 4th, 2017