Benralizumab Shows Sustained Remission in Severe Eosinophilic Asthma for Up to Two Years: Study

A new study published in the journal of CHEST showed that benralizumab reduces exacerbations, especially in older individuals, and produces prolonged clinical remission in patients with severe eosinophilic asthma (SEA), with 39% of patients experiencing remission at 48 weeks and 31% retaining it at 96 weeks.

Eosinophilic phenotype, which includes blood eosinophilia and eosinophilic airway inflammation, is seen in most people with severe asthma. A humanized monoclonal antibody called benralizumab attaches itself to the alpha subunit of the interleukin-5 receptor (IL-5Rα) on basophils, eosinophils, and eosinophilic precursors.

Through increased antibody-dependent cell-mediated cytotoxicity, it causes the peripheral blood and tissue eosinophils to be rapidly and nearly completely depleted. Despite the fact that symptom management has historically been the main emphasis of treatment, the introduction of biologics has changed the landscape of SEA treatment, and clinical remission is now included as an aspirational objective in worldwide recommendations. In order to report clinical remission over a 2-year period in patients with SEA following benralizumab, this research was carried out.

Adults with SEA who received benralizumab for ≤96 weeks participated in the global, retrospective, real-world XALOC-1 program. Weeks 0, 48, and 96 were used to determine the percentage of patients who met the components and composite of clinical remission, which include no exacerbations, no use of maintenance oral corticosteroids [mOCS], and well-controlled asthma [Asthma Control Test score ≥20 or 6-item Asthma Control Questionnaire score ≤0.75]. Using multivariable logistic regression analysis, the relationship between important baseline demographics, clinical features, and clinical remission status was evaluated at Weeks 48 and 96.

At Weeks 0, 48, and 96, 0.4%, 39%, and 31% of the 1070 patients, respectively, achieved the 3-component clinical remission criteria. Remission occurred in 43% of patients who were biologic-naïve (Week 48) and 32% of patients who were biologic-experienced (Week 96), respectively. Meeting the criteria for clinical remission at Week 96 was positively correlated with a lower mOCS dosage, a lower body mass index, and a higher peak eosinophil count at baseline.

Overall, about one-third of SEA patients taking benralizumab achieve clinical remission, which is a feasible objective that lasts for up to two years. The patients with lower baseline illness load were more likely to have remission, indicating that additional study is necessary to determine if earlier biologic beginning may be advantageous.

Reference:

Pelaia, G., Jackson, D. J., Nair, P., Emmanuel, B., Tran, T. N., Menzies-Gow, A., Watt, M., Kayaniyil, S., Boarino, S., Nuevo, J., Pardal, M., Shavit, A., Shih, V. H., Cohen, D., Loureiro, C., & Padilla-Galo, A. (2025). XALOC-1: Clinical remission over 2-years with benralizumab in severe eosinophilic asthma. Chest. https://doi.org/10.1016/j.chest.2025.04.011