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This section of First Report Managed Care focuses on reporting the latest in health care economics and outcomes research for a variety of treatments and disease states.

Per the results of a recent study, benralizumab, an interleukin-5 receptor α antibody, improved symptoms and pulmonary function, as well as reduced the frequency of exacerbation, for patients with severe asthma resistant to existing treatments.

The retrospective study results were presented at the 2020 American Academy of Allergy, Asthma & Immunology Annual Meeting, for which science was posted digitally due to COVID-19.

In patients with eosinophilic severe asthma, benralizumab has been said to be effective for patients with eosinophilic severe asthma. Hirofumi Watanabe, MD, department of respiratory medicine, Shizuoka General Hospital, Shizuoka, Japan, and colleagues designed a 24-patient study to clarify the usefulness and benefits of benralizumab between April 2018 and July 2019.

Researchers evaluated clinical parameters at 4 weeks and 24 weeks after administration. The goal primary outcome measured using an ROC analysis was “improvement of FEV1 with minimum significant difference of 10.38%. Clinical parameters included the Global Evaluation of Treatment Effectiveness (GETE) scale, Asthma Control Test (ACT), Asthma Control Questionnaire-5 (ACQ-5),Peripheral eosinophil count, FeNO (NIOX-VERO), Pulmonary function (CHESTAC-8800)

The researchers explained that the minimal clinically important difference (MCID) of ACT is 3 points and MCID of ACQ is 0.5 points within-person change. The study also compared exacerbation frequency from 6 months prior to benralizumab administration to 6 months post administration.

“Of the 24 patients, 21 completed the treatment for 24 weeks,” Dr Watanabe and colleagues explained. “ACT and ACQ improved in 64% and 76% of the patients, respectively, at 4 weeks, and the effect continued until 24 weeks. The dose was reduced in 10 of 16 patients administered with oral corticosteroid.

More notable results of the study include:

  • The mean FEV1 improved at 4 weeks.
  • Moderate positive correlation was found between the improvement rate of FEV1 and eosinophil count before treatment (rho=0.653)
  • ROC analysis revealed that a 10% improvement in FEV1 was predicted by the eosinophil count before treatment with the best cut-off value of 200/μl.

For patients without increased blood eosinophils, FEV1 improvement was minimal but 40% of patients needed fewer steroid doses and symptom scores improved.

“In patients who completed benralizumab for 24 weeks, the frequency of exacerbations was significantly reduced compared with that 24 weeks before administration (19% vs 51%, p=0.006),” explained the researchers.

Ultimately, the researchers concluded: “Benralizumab improved pulmonary function, depending on peripheral blood eosinophil count and symptoms, and reduced the frequency of exacerbation.”

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—Edan Stanley

Reference:
Watanabe H, Akamatsu T, Hirai K, et al. Effectiveness of benralizumab in patients with severe asthma. Poster presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting; March 13–16, 2020; Philadelphia, PA, USA.


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