Influence of allergic status and nasal polyposis on long-term Benralizumab response in eosinophilic severe asthma
V. 174 N. 1 (2023), Observational Study
V. 174 N. 1 (2023)

Influence of allergic status and nasal polyposis on long-term Benralizumab response in eosinophilic severe asthma: doi: 10.7417/CT.2023.2499

Observational Study
Pubblicato 2023-01-18
B. Sposato
Pneumology Department, Azienda USL Toscana Sud-Est, “Misericordia” Hospital, Grosseto
A. Ricci
Division of Pneumology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, AOU Sant‘Andrea, Rome, Italy
G. Camiciottoli
Section of Respiratory Medicine, Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, Florence, Italy;
G. E. Carpagnano
Institute of Respiratory Diseases, Department of Medical and Surgical Sciences, University of Foggia, Italy
C. Pelaia
Department of Medical and Surgical Sciences, Section of Respiratory Diseases, University “Magna Græcia” of Catanzaro, Catanzaro, Italy
P Santus
Department of Biomedical and Clinical Sciences (DIBIC), Università Degli Studi di Milano, Division of Pulmonary Diseases, Ospedale L. Sacco, ASST Fatebenfratelli-Sacco, Milan, Italy
G. Pelaia
Department of Medical and Surgical Sciences, Section of Respiratory Diseases, University “Magna Græcia” of Catanzaro, Catanzaro, Italy
G. Palmiero
Pneumology Department, Azienda USL Toscana Nord Ovest, “Versilia” Hospital, Lido di Camaiore (LU), Italy
M. Di Tomassi
Pneumology Department, Azienda USL Toscana Sud-Est, “S. Andrea” Hospital, Massa Marittima (GR), Italy
M. C. Ronchi
Pneumology Department, Azienda USL Toscana Sud-Est, “S. Andrea” Hospital, Massa Marittima (GR), Italy
P. Cameli
Department of Medicine, Surgery and Neurosciences, Respiratory Diseases and Lung Transplant Unit, University of Siena, Siena, Italy
E. Bargagli
Department of Medicine, Surgery and Neurosciences, Respiratory Diseases and Lung Transplant Unit, University of Siena, Siena, Italy
L. Ciambellotti
Section of Respiratory Medicine, Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, Florence, Italy
S. Rizzello
Section of Respiratory Medicine, Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, Florence, Italy
R. Sglavo
Division of Pneumology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, AOU Sant‘Andrea, Rome, Italy
A. Coppola
Division of Respiratory Disease, San Filippo Neri Hospital, Rome, Italy
L. G. Lacerenza
Department of Pharmaceutical Medicine, Azienda USL Toscana Sud-Est, “Misericordia” Hospital, Grosseto, Italy
M. Gabriele
Respiratory Unit, department of Experimental Medicine, University of Rome “Tor Vergata” Rome, Italy
D. Radovanovic
Department of Biomedical and Clinical Sciences (DIBIC), Università Degli Studi di Milano, Division of Pulmonary Diseases, Ospedale L. Sacco, ASST Fatebenfratelli-Sacco, Milan, Italy
A. Perrella
Pneumology Department, Azienda USL Toscana Sud-Est, “Misericordia” Hospital, Grosseto, Italy
P. Rogliani
Respiratory Unit, department of Experimental Medicine, University of Rome “Tor Vergata” Rome, Italy
M. Scalese
Clinic Physiology Institute, National Research Centre, Pisa, Italy
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Parole chiave

Benralizumab
.severe asthma
real-life
lung function
small airways
symptoms
oral corticosteroids
long-term
effectiveness

Abstract

Objective.
It is unclear whether Benralizumab effectiveness in severe eosinophilic asthma can be influenced by nasal polyposis (NP) or allergic status associations. We evaluated whether Benralizumab long-term efficacy in asthma outcomes could be different in subjects with atopy (SAEA) compared to the effectiveness in those without allergies (SNAEA) and in individuals with NP compared to those without NP.

Methods.
This observational retrospective study considered 95 consecutive patients divided into allergic (SAEA; n:65[68.4%]; skin prick tests positive [SPT] and/or IgE values ≥100 UI/mL), and non-allergic (SNAEA; n:30[31.6%], SPT negative and normal IgE levels<100 UI/ mL). Overall population was also divided into two groups according to NP presence (NP+:39[41%] and NP-:56[59%]). Benralizumab treatment mean was19.7±7.2 months (range 12-35).

Results.
No differences in Benralizumab effectiveness were found in asthma outcomes in patients with/without NP. SNOT-22 improvement was higher in NP+ (-22±24) compared to NP- groups (6.33±15.5;p=0.055). FEV1 (16.33±19.22%), ACT(7.45±3.95)
increases and frequency of SABA use (3.37±4.99) reduction were higher in SAEA compared to what obtained in non-allergic subjects (FEV1:8.15±15.6%,p=0.043; ACT:4.89±3.57,p=0.005; SABA use:- 1.16±1.84;p=0.015). 93.8% of SAEA patients whereas only 72.2% of SNAEA individuals reduced OC doses at least half after Benralizumab (p=0.035). These results were partially confirmed by linear regression models showing associations between allergic status and FEV1, ACT and SABA use changes (β=8.37;p=0.048, β=2.056;p=0.033 and β=-2.184;p=0.042 respectively).

Conclusion. Benralizumab effectiveness in asthma appears to be independent of NP presence. The allergic eosinophilic disease, compared to just eosinophilic asthma, may be a more severe phenotype.
Benralizumab may have greater efficacy in SAEA on some outcomes.

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