Campisi Raffaele, Nolasco Santi, Pelaia Corrado, Impellizzeri Pietro, D'Amato Maria, Portacci Andrea, Ricciardi Luisa, Scioscia Giulia, Crimi Nunzio, Scichilone Nicola, Foschino Barbaro Maria Pia, Pelaia Girolamo, Carpagnano Giovanna Elisiana, Vatrella Alessandro, Crimi Claudia
Respiratory Medicine Unit, Policlinico "G. Rodolico-San Marco" University Hospital, 95123 Catania, Italy.
Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
J Clin Med. 2023 Jun 9;12(12):3953. doi: 10.3390/jcm12123953.
: The co-presence of bronchiectasis (BE) in severe eosinophilic asthma (SEA) is common. Data about the effectiveness of benralizumab in patients with SEA and BE (SEA + BE) are lacking. : The aim of this study was to evaluate the effectiveness of benralizumab and remission rates in patients with SEA compared to SEA + BE, also according to BE severity. : We conducted a multicentre observational study, including patients with SEA who underwent chest high-resolution computed tomography at baseline. The Bronchiectasis Severity Index (BSI) was used to assess BE severity. Clinical and functional characteristics were collected at baseline and after 6 and 12 months of treatment. : We included 74 patients with SEA treated with benralizumab, of which 35 (47.2%) showed the co-presence of bronchiectasis (SEA + BE) with a median BSI of 9 (7-11). Overall, benralizumab significantly improved the annual exacerbation rate ( < 0.0001), oral corticosteroids (OCS) consumption ( < 0.0001) and lung function ( < 0.01). After 12 months, significant differences were found between SEA and SEA + BE cohorts in the number of exacerbation-free patients [64.1% vs. 20%, OR 0.14 (95% CI 0.05-0.40), < 0.0001], the proportion of OCS withdrawal [-92.6% vs. -48.6, = 0.0003], and the daily dose of OCS [-5 mg (0 to -12.5) vs. -12.5 mg (-7.5 to -20), = 0.0112]. Remission (zero exacerbations + zero OCS) was achieved more frequently in the SEA cohort [66.7% vs. 14.3%, OR 0.08 (95% CI 0.03-0.27), < 0.0001]. Changes in FEV% and FEF were inversely correlated with BSI ( = -0.36, = 0.0448 and = -0.41, = 0.0191, respectively). : These data suggest that benralizumab exerts beneficial effects in SEA with or without BE, although the former achieved less OCS sparing and fewer respiratory-function improvements.
重度嗜酸性粒细胞性哮喘(SEA)合并支气管扩张(BE)的情况很常见。目前缺乏关于贝那利珠单抗对SEA合并BE(SEA+BE)患者有效性的数据。本研究旨在评估贝那利珠单抗的有效性以及与SEA+BE患者相比SEA患者的缓解率,并根据BE严重程度进行分析。我们开展了一项多中心观察性研究,纳入了基线时接受胸部高分辨率计算机断层扫描的SEA患者。采用支气管扩张严重程度指数(BSI)评估BE严重程度。在基线以及治疗6个月和12个月后收集临床和功能特征。我们纳入了74例接受贝那利珠单抗治疗的SEA患者,其中35例(47.2%)合并支气管扩张(SEA+BE),BSI中位数为9(7-11)。总体而言,贝那利珠单抗显著改善了年加重率(P<0.0001)、口服糖皮质激素(OCS)用量(P<0.0001)和肺功能(P<0.01)。12个月后,SEA组和SEA+BE组在无加重患者数量[64.1%对20%,OR 0.14(95%CI 0.05-0.40),P<0.0001]、OCS停用比例[-92.6%对-48.6%,P=0.0003]以及OCS每日剂量[-5mg(0至-12.5)对-12.5mg(-7.5至-20),P=0.0112]方面存在显著差异。SEA组更频繁地实现缓解(零次加重+零OCS)[66.7%对14.3%,OR 0.08(95%CI 0.03-0.27),P<0.0001]。FEV%和FEF的变化与BSI呈负相关(分别为r=-0.36,P=0.0448和r=-0.41,P=0.0191)。这些数据表明,无论有无BE,贝那利珠单抗对SEA均有有益作用,尽管SEA组在节省OCS和改善呼吸功能方面效果较差。