Benralizumab Increases Morning PEF in Patients with Eosinophilic Asthma

Researchers evaluated the onset of action of the monoclonal antibody benralizumab by assessing changes in morning peak expiratory flow (PEF). Geoffrey Chupp, MD, of the Yale Center for Asthma and Airway Disease in New Haven, Connecticut, and colleagues found that benralizumab produced rapid and sustained increases in morning PEF in patients with severe, uncontrolled eosinophilic asthma. The results were presented at the 2018 AAAAI Annual Meeting.

They used data from the phase III SIROCCO and CALIMA trials to identify patients ≥12 years old who were receiving high-dose inhaled corticosteroid/long-acting beta-agonists with baseline blood eosinophils ≥300 cells/mL.

Patients in the 48-week SIROCCO and 56-week CALIMA trials received:

• Benralizumab 30 mg every 8 weeks (every 4 weeks for the first 3 doses; SIROCCO, n=267; CALIMA, n=239)
• Placebo (SIROCCO, n=267; CALIMA, n=248)

In this post-hoc analysis, the researchers assessed patients’ average weekly changes in morning PEF from baseline to end of treatment.

Compared with placebo, benralizumab increased the mean morning PEF changes by 22.74 L/min (95% confidence interval [CI], 21.25-24.20) in the SIROCCO study and by 23.73 L/min (95% CI, 22.52-24.99) in the CALIMA study.

The researchers observed differences in mean PEF changes from baseline during the first week among those treated with benralizumab versus placebo for both trials:

• SIROCCO: 14.05 L/min (95% CI, 13.16-14.96) vs 7.16 L/min (95% CI, 6.28-7.99)
• CALIMA: 14.58 L/min (95% CI, 13.71-15.83) vs 8.75 L/min (95% CI, 7.91-9.65)

The mean time to achieve a 25 L/min increase in morning PEF with benralizumab was 20.7 days in the SIROCCO trial (95% CI 19.3-22.1) and 20.0 days in the CALIMA trial (95% CI 18.6-21.7). Those receiving placebo did not achieve a 25 L/min increase in either trial.

Source: Chupp G, Ferguson GT, Hirsch I, et al. Benralizumab treatment produces rapid changes in morning peak expiratory flow in patients with severe, uncontrolled eosinophilic asthma. Abstract #44. Presented at the 2018 AAAAI Annual Meeting, March 2-5, 2018, Orlando, FL.