Sustained asthma control and remission in real-world patients with severe eosinophilic asthma receiving benralizumab: XALOC-2

OBJECTIVE: Prospective real-world data on remission rates in patients with severe eosinophilic asthma (SEA) treated with benralizumab for more than 1 year are currently lacking. Here we investigate the long-term effectiveness of benralizumab treatment over 2 years on symptom control, clinical outcomes, and remission rates in real-world patients with SEA. METHODS: XALOC-2 is a prospective, observational real-world study in adults with SEA in Belgium, Canada, Germany, and Switzerland. Three-component clinical remission (3-CR; defined as the absence of exacerbations and oral corticosteroid use [over a 12-month period], and the presence of good asthma control [asthma control questionnaire (ACQ) thresholds of ≤0.75 or <1.5]), was assessed at Weeks 0/56/112. RESULTS: Among the 534 patients analyzed, median (interquartile range [IQR]) age at benralizumab treatment initiation was 58.0 (48.0-66.0) years; 76.3% had adult-onset asthma, and 49.3% were female. The median (IQR) ACQ score decreased from 3.0 (2.2-3.8) at baseline to 1.2 (0.6-2.3) at Week 56 and remained stable at Week 112 (1.2 [0.5-2.2]). When using the strictest ACQ threshold (≤0.75), the proportion of patients with 3-CR at Week 56 (27%) remained nearly unchanged at Week 122 (25%). A similar stability of 3-CR was observed when using the less strict ACQ threshold (<1.5): 42% at Week 56 and 41% at Week 112. CONCLUSIONS: Real-world patients with SEA showed early and sustained disease control and sustained remission rates after 2 years of benralizumab treatment. Even with the strictest ACQ threshold for asthma control, more than one-quarter of patients were in remission after 2 years of benralizumab.