Brussino Luisa, Aliani Maria, Altieri Elena, Bracciale Pietro, Caiaffa Maria Filomena, Cameli Paolo, Canonica Giorgio Walter, Caruso Cristiano, Centanni Stefano, De Michele Fausto, Del Giacco Stefano, Di Marco Fabiano, Malerba Laura, Menzella Francesco, Pelaia Girolamo, Rogliani Paola, Romagnoli Micaela, Schino Pietro, Schroeder Jan Walter, Senna Gianenrico, Vultaggio Alessandra, D'Amato Maria
Dipartimento di Scienze Mediche, Università degli Studi di Torino; SCDU Immunologia e Allergologia, AO Ordine Mauriziano Umberto I, Torino, Italy.
UO Pneumologia e Pneumologia Riabilitativa, ICS Maugeri, IRCCS Bari, Bari, Italy.
Front Allergy. 2025 Mar 20;6:1501196. doi: 10.3389/falgy.2025.1501196. eCollection 2025.
Severe eosinophilic asthma (SEA) often co-occurs with chronic rhinosinusitis with nasal polyps (CRSwNP), worsening asthma symptoms. Earlier studies have shown that benralizumab improves asthma outcomes with greater efficacy if patients present CRSwNP.
This analysis of the ANANKE study (NCT04272463) reports data on the long-term effectiveness of benralizumab between SEA patients with and without CRSwNP ( = 86 and = 75, respectively) treated for up to 96 weeks.
Before benralizumab initiation, CRSwNP patients displayed longer SEA duration, greater oral corticosteroid (OCS) use and blood eosinophil count. After 96 weeks of treatment, the annual exacerbation rate (AER) decreased in both groups, with CRSwNP patients achieving considerable reductions than No-CRSwNP patients (severe AER dropped by 100% and 95.6%, respectively). While lung function improvement was comparable at week 96, CRSwNP patients showed a faster response to benralizumab, with a rise of forced expiratory volume in 1 s (FEV) at 16 weeks that was maintained throughout the study. Median OCS daily dose decreased to 0.0 mg in both groups at 96 weeks, but benralizumab OCS-sparing effect was faster in CRSwNP patients (median OCS dose was 0.0 mg and 2.5 mg in CRSwNP and No-CRSwNP patients respectively, at 48 weeks). Although asthma control test (ACT) median scores were comparable, greater proportions of CRSwNP patients displayed well-controlled asthma (ACT ≥ 20) than No-CRSwNP patients at all time points.
These findings show benralizumab long-term effectiveness in SEA patients with and without CRSwNP, highlighting its superior and faster-acting benefits on asthma outcomes in presence of CRSwNP.
重度嗜酸性粒细胞性哮喘(SEA)常与伴有鼻息肉的慢性鼻-鼻窦炎(CRSwNP)同时出现,会使哮喘症状恶化。早期研究表明,如果患者患有CRSwNP,贝那利珠单抗能更有效地改善哮喘预后。
这项对ANANKE研究(NCT04272463)的分析报告了在长达96周的治疗中,有和没有CRSwNP的SEA患者(分别为86例和75例)使用贝那利珠单抗的长期有效性数据。
在开始使用贝那利珠单抗之前,CRSwNP患者的SEA病程更长,口服糖皮质激素(OCS)的使用量和血液嗜酸性粒细胞计数更高。治疗96周后,两组的年度加重率(AER)均下降,CRSwNP患者的下降幅度比无CRSwNP患者更大(重度AER分别下降了100%和95.6%)。虽然在第96周时肺功能改善情况相当,但CRSwNP患者对贝那利珠单抗的反应更快,在第16周时1秒用力呼气量(FEV)增加,并在整个研究过程中保持。在96周时,两组的OCS每日中位剂量均降至0.0毫克,但贝那利珠单抗在CRSwNP患者中更快产生减少OCS用量的效果(在第48周时,CRSwNP患者和无CRSwNP患者的OCS中位剂量分别为0.0毫克和2.5毫克)。尽管哮喘控制测试(ACT)的中位评分相当,但在所有时间点,显示哮喘得到良好控制(ACT≥20)的CRSwNP患者比例均高于无CRSwNP患者。
这些发现表明贝那利珠单抗在有和没有CRSwNP的SEA患者中均具有长期有效性,突出了其在存在CRSwNP时对哮喘预后的卓越且起效更快的益处。