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Browse ATS 2021 Abstracts

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ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.

Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.

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Clinical Effectiveness of Benralizumab Is Independent of Baseline FeNO in Severe Eosinophilic Asthma: A Retrospective Real-World Observation Study in Five UK Severe Asthma Centers

Session Title
TP6 - TP006 CLINICAL STUDIES OF ALLERGIC AIRWAY DISEASES, LUPUS, AND EOSINOPHILIC DISEASES
Abstract
A1360 - Clinical Effectiveness of Benralizumab Is Independent of Baseline FeNO in Severe Eosinophilic Asthma: A Retrospective Real-World Observation Study in Five UK Severe Asthma Centers
Author Block: D. J. Jackson1, H. Burhan2, A. Menzies-Gow3, P. E. Pfeffer4, A. Nanzer5, E. Garcia Gil6, T. Morris7, T. N. Tran8, I. Hirsch7, S. Dube7; 1Guy's Severe Asthma Center, Guy's & St. Thomas' NHS Trust; Asthma UK Centre, School of Immunology & Microbial Sciences, King’s College London, London, United Kingdom, 2Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom, 3Royal Brompton Hospital, London, United Kingdom, 4Dept of Respiratory Medicine, Barts Health NHS Trust, London, United Kingdom, 5Guy's Severe Asthma Center, Guy's & St. Thomas' NHS Trust, London, United Kingdom, 6AstraZeneca, Barcelona, Spain, 7BioPharmaceuticals R&D, AstraZeneca, Luton, United Kingdom, 8AstraZeneca, Gaithersburg, MD, United States.
Rationale: Fractional exhaled nitric oxide (FeNO) is a predictive factor for asthma exacerbations, with increased levels associated with a high frequency of exacerbations and healthcare resource utilization. The anti-IL-5Rα monoclonal antibody, benralizumab, depletes blood eosinophils, which are a cellular source of the cytokine IL-13 known to promote NO-synthase activity and NO production. There is a paucity of real-world data on the effect of benralizumab on FeNO and clinical outcomes in patients with severe eosinophilic asthma (SEA) and high FeNO levels.
Methods: This retrospective observational study conducted in five UK severe asthma centers describes response to benralizumab in low (<50 ppb) and high (≥50 ppb) FeNO SEA patients treated with benralizumab for at least 12 months. Outcomes assessed were FeNO, exacerbation rate, maintenance oral corticosteroid (mOCS) use and asthma control (ACQ-6) after 48 weeks of benralizumab therapy. After treatment with benralizumab, patients were classified as responders and super responders. Responders were defined as ≥50% reduction in exacerbations for patients with baseline exacerbation or ≥50% reduction in mOCS. Patients without exacerbations or mOCS after 48 weeks of benralizumab therapy were classified as “super-responders.”
Results: Of the 208 participants in this study, 63% were female. Mean age (SD) at benralizumab initiation was 51 (15), and median baseline blood eosinophils of 500 cells/µL (interquartile range [IQR], 300-800). Of the patients with baseline FeNO records (n=177), median FeNO was 65 ppb (IQR, 36-100), 38% had FeNO below 50 ppb and 62% FeNO ≥50 ppb. At 48 weeks after benralizumab initiation, median FeNO levels substantially declined by 42% in patients with high FeNO. Clinical response to benralizumab was independent of baseline FeNO, with similar improvements observed in exacerbation rate reduction (89% vs. 87%), mOCS elimination (57% vs. 52%), and ACQ-6 score mean change (-0.8 vs. -1.1) in patients with <50 ppb and ≥50 ppb baseline FeNO, respectively (Table). Similar proportions of patients (83% [95% confidence interval (CI); 74%-92%] vs. 84% [95% CI 77%-91%]) were classified as responders, whereas 59% [95% CI 46%-71%] vs. 58% [95% CI 48%-67%] met super-responder criteria for FeNO <50 ppb and ≥50 ppb.
Conclusions: In this real-world cohort of SEA, benralizumab was associated with a clinically meaningful reduction in FeNO in patients with a high baseline FeNO ≥50 ppb. In this study, patients treated with benralizumab experienced substantial reduction in exacerbation risk and use of mOCS and improved asthma control independent of baseline FeNO.