Menzella Francesco, Bonavia Marco, Bonini Matteo, D'Amato Maria, Lombardo Salvatore, Murgia Nicola, Patella Vincenzo, Triggiani Massimo, Pelaia Girolamo
Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia-IRCCS, Reggio Emilia, Italy.
Pneumologia Riabilitativa - Ospedale Ge-Arenzano, ASL3-, Genoa, Italy.
J Asthma Allergy. 2021 Feb 22;14:149-161. doi: 10.2147/JAA.S295676. eCollection 2021.
Severe eosinophilic asthma (SEA) is characterized by high eosinophilia, severe symptoms, important comorbidities, frequent exacerbations, and poor asthma control. Benralizumab, targeting the interleukin-5 receptor alpha, proved effective in inducing rapid eosinophil depletion and amelioration of symptoms and lung function; it also allowed to reduce exacerbations and the use of oral corticosteroids (OCS). The present case series, spanning different subtypes of SEA, aimed at expanding the real-world experience with benralizumab in Italy.
We collected data from SEA patients treated with benralizumab, at baseline and during treatment. We focused on the effects of benralizumab in the following conditions and endpoints: i) overlap between high-IgE and high-eosinophilic asthma; ii) presence of nasal polyposis as comorbidity; iii) corticosteroid-sparing effect; iv) patient perception.
Ten SEA patients (females: N=7; age range: 19-70 years) referred to 8 Italian Centers and treated with benralizumab were included, presenting with several comorbidities such as non-allergic disease (8/10), atopy (3/10), high IgE (5/10) and nasal polyposis (6/10). Overall, benralizumab yielded optimal disease control in all patients, particularly in terms of rapid clinical and functional improvement, decreased systemic steroid need (OCS therapy was completely discontinued in 7 cases) and amelioration of patient quality of life, except for 1 case, in whom other conditions not related to benralizumab therapy interfered with the patient perception.
Our findings further support the efficacy and safety of benralizumab observed in randomized clinical trials, providing even better results for lung function improvement.
重度嗜酸性粒细胞性哮喘（SEA）的特征为嗜酸性粒细胞增多、症状严重、重要合并症、频繁发作以及哮喘控制不佳。靶向白细胞介素-5受体α的贝那利珠单抗已被证明可有效诱导嗜酸性粒细胞快速减少，并改善症状和肺功能；它还能减少发作次数以及口服糖皮质激素（OCS）的使用。本病例系列涵盖了SEA的不同亚型，旨在扩展意大利使用贝那利珠单抗的真实世界经验。
我们收集了接受贝那利珠单抗治疗的SEA患者在基线和治疗期间的数据。我们重点关注贝那利珠单抗在以下情况和终点的效果：i）高IgE与高嗜酸性粒细胞性哮喘的重叠；ii）合并鼻息肉病；iii）糖皮质激素节省效应；iv）患者感受。
纳入了10例转诊至8个意大利中心并接受贝那利珠单抗治疗的SEA患者（女性：N = 7；年龄范围：19 - 70岁），这些患者存在多种合并症，如非过敏性疾病（8/10）、特应性（3/10）、高IgE（5/10）和鼻息肉病（6/10）。总体而言，除1例患者外，贝那利珠单抗在所有患者中均实现了最佳疾病控制，特别是在临床和功能快速改善、全身类固醇需求减少（7例患者完全停用OCS治疗）以及患者生活质量改善方面，该例患者中与贝那利珠单抗治疗无关的其他情况影响了患者感受。
我们的研究结果进一步支持了在随机临床试验中观察到的贝那利珠单抗的疗效和安全性，在改善肺功能方面提供了更好的结果。
