D3.135 - Real World Efficacy of Benralizumab Treatment in Severe Eosinophilic Asthma: A Single-Center Experience

Benralizumab,a biologic treatment option for severe eosinophilic asthma (SEA), binds to the IL-5 receptor α on eosinophils, eosinophilic precursors, and basophils. This action inhibits IL-5 binding and induces rapid apoptosis via antibody-dependent cellular cytotoxicity. While the efficacy of benralizumab has been demonstrated in various randomised controlled trials, real-world data regarding its clinical use remain limited

We retrospectively evaluated the clinical characteristics and treatment responses of all patients diagnosed with SEA who received benralizumab for at least 4 months in our clinic between 2024 and 2025. Clinical outcomes, including Asthma Control Test (ACT) scores, oral corticosteroid (OCS) use, and the frequency of clinically significant exacerbations (requiring ≥ 3 days of OCS) were recorded at baseline, week 16, and week 52. For patients completing at least one year of treatment, clinical remission was assessed and defined based on the achievement of all of the following three criteria: an ACT score of ≥ 20, no requirement for systemic steroids, and the absence of exacerbations within the previous year

A total of 24 patients (mean age 47.5 ± 11.25 years; 83.3% female) who received benralizumab treatment for a period ranging from 4 to 20 months were included in the study. While benralizumab was the first biologic for 29.2% (n=7) of the patients, 70.8% (n=17)  had prior exposure to other biologic agents such as omalizumab and/or mepolizumab. Mean ACT scores significantly improved from 12.3 ± 2.79 at baseline to 20.5 ± 4.15 at week 16 (n=24, p=0.001). Among the 14 patients who completed 52 weeks of treatment ACT scores further increased from 11.8 ± 2.58 to 21.7 ±  3.96 (p=0.001). At one year, the annual exacerbation rate decreased by 61.5% and the mean annual cumulative OCS requirement decreased by 77.9% (470.8 ± 332.14 vs 103.8 ± 153.37 mg/year, methylprednisolone)(p =0.005). Overall, clinical remission was achieved in 35.7% (n=5) at week 52. At week 52 clinical remission was reached in 35.7% of the patients overall and 22.2% of those who had previously failed other biologic treatments

In this case series, primarily consisting of patients with a history of prior biologic failure (70.8%), benralizumab significantly reduced exacerbation rates and OCS requirements while markedly improving symptom control. At week 52 clinical remission was reached in 35.7% of the patients overall and 22.2% of those who had previously failed other biologic treatments