Rapid Benralizumab effectiveness in patients with severe eosinophilic asthma and bronchiectasis

Background: Benralizumab reduces eosinophils both in sputum and peripheral blood, oral corticosteroid intake (OCS), improves pulmonary function and asthma control. Association between asthma and bronchiectasis (BE) is quite frequent, particularly in patients with severe asthma. Aim: To evaluate the short-term effect of benralizumab in patients with severe eosinophilic asthma and BE. Materials and Methods: We retrospectively included 17 patients (5M/12F) with severe asthma treated with benralizumab. All patients underwent high-resolution computed tomography (HRCT) to assess BE diagnosis. Blood and sputum eosinophils, FEV1, OCS daily dose and Asthma Control Test (ACT)and Visual analogic scale (VAS) for sputum production at baseline and after 1 months of therapy were recorded. Results: BE were identified in 10 patients (58.82%). Compared to baseline after 1 months, we found a statistically significant reduction of eosinophils in peripheral blood (686 ± 428 cells/μL to 22.22 ± 67 cells/μL; p<0.001), sputum eosinophils (58.22±37.16% to 1.4±1.14%; p<0.003) and improvement in FEV1 (67.8 ± 22.65% to 101.22 ± 23.6%; p<0.05). ACT ranges from 13.55±5.36 to 20.33±3.77 (p <0.001), reaching the critical threshold of 20, indicative of a good overall asthma control after only one dose benralizumab administration. No statistically significance was found for OCS daily intake of prednisone (7.22 ± 8.33 mg to 3.05 ± 4.96 mg; p=0.16). Reduction in sputum production was found after treatment (VAS 5 to 8, p<0.05) Conclusion: Benralizumab determined a very rapid clinical and functional improvement in patients with severe eosinophilic asthma and BE.