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Benralizumab for eosinophilic granulomatosis with polyangiitis
Adrien Cottu1, Matthieu Groh2, Charlene Desaintjean3
1Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hospital Cochin, Paris, France.
Annals of the Rheumatic Diseases
|August 7, 2023
Summary
Benralizumab shows effectiveness in treating eosinophilic granulomatosis with polyangiitis (EGPA), particularly for refractory asthma and ENT issues, enabling reduced glucocorticoid use. However, prior mepolizumab treatment may lower benralizumab
Area of Science:
- Immunology
- Rheumatology
- Pulmonology
Background:
- Benralizumab is approved for eosinophilic asthma and explored for other eosinophil-driven diseases.
- Limited data exists on benralizumab for eosinophilic granulomatosis with polyangiitis (EGPA).
Purpose of the Study:
- To evaluate the efficacy and safety of off-label benralizumab in EGPA patients.
- To assess treatment response rates and glucocorticoid-sparing effects.
Main Methods:
- Multicentre retrospective study of 68 EGPA patients treated with benralizumab.
- Primary endpoint: complete response (Birmingham Vasculitis Activity Score=0, prednisone ≤4 mg/day).
- Secondary endpoint: partial response (Birmingham Vasculitis Activity Score=0, prednisone ≥4 mg/day).
Main Results:
- 49% achieved complete response, 36% partial response; 15% showed no response.
- Glucocorticoids were discontinued in 38% of patients.
- Prior mepolizumab use was linked to higher treatment failure and less glucocorticoid discontinuation.
Conclusions:
- Benralizumab is effective for refractory asthma/ENT symptoms in EGPA, facilitating glucocorticoid reduction.
- Efficacy of benralizumab may be reduced in patients with prior mepolizumab treatment failure.
- Further research is needed to optimize benralizumab use in EGPA.
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