February 26, 2022—Phoenix, Arizona—Use of benralizumab in patients aged 12 and over with severe eosinophilic asthma results in significant reduction in asthma exacerbations, oral corticosteroid use, and healthcare resources utilization, according to a real-world analysis presented at the American Academy of Allergy, Asthma, & Immunology Annual Meeting, which took place here and online from February 25 to 28.
“Over 80% of patients with severe asthma have eosinophilic asthma,” said lead author Donna D. Carstens, MD, of AstraZeneca in Wilmington, during her presentation of the data. “Benralizumab is an add-on biologic therapy for severe asthma and has been shown to reduce asthma exacerbation rates and oral corticosteroid use in clinical trials and observational studies.”
To better characterize the benefits of benralizumab in a real-world setting, Dr. Carstens and colleagues used data from a large US insurance claims dataset covering the period of November 2016 through June 2019 to conduct ZEPHYR 2, a retrospective cohort study examining patients with asthma treated with benralizumab.
The primary cohort included patients aged 12 and older who had 2 or more records of benralizumab use and at least 2 asthma exacerbations in the 1-year pre-index period. The patients were divided into two subgroups: 1) persistent users with at least 6 records of benralizumab use, and 2) patients who were oral corticosteroid dependent pre-index, defined as a cumulative dose of at least 450 mg prednisone equivalent oral corticosteroid use over 90 consecutive days or at least a 180-day supply of oral corticosteroids during the 1-year pre-index period.
The primary outcome was the reduction in asthma exacerbations from the 1-year pre-index to the 1-year post-index period.
Among the 1292 patients included in the study, 708 were persistent users, and 1065 were oral corticosteroid dependent. Overall, patients had a mean age of 51.2 years, and 69.5% were women. Common comorbidities included allergic rhinitis, hypertension, gastroesophageal reflux disease, obesity, and hyperlipidemia. Baseline characteristics were similar in the two subgroups.
The duration of benralizumab use was approximately 215 days in the primary cohort and the oral corticosteroid-dependent cohort and 392 days in the persistent cohort.
In the primary cohort, there was a 59% reduction in asthma exacerbations post-index, compared with pre-index (P < .001). Consistent exacerbation reductions were observed for both the persistent users (61% reduction, P < .001) and the oral corticosteroid-dependent users (58% reduction, P < .001).
Similarly, there were significant reductions in both healthcare resource utilization related to asthma exacerbations with the use of benralizumab. This included significant reductions in inpatient stays (58% reduction, P < .001), emergency department visits (54% reduction, P < .001), and outpatient visits (58% reduction, P < .001). Medical costs were significantly reduced, by 49% to 52%. Finally, there was a significant reduction in oral corticosteroid dependence with benralizumab, ranging from 37% to 42% in all cohorts. Oral corticosteroid and background medication use were significantly reduced from the pre-index to the post-index period in the primary cohort and both subgroups.
“In this real-world analysis, patients treated with benralizumab experienced a significant reduction in asthma exacerbations,” concluded Dr. Carstens. “Similarly, those with persistent use and oral corticosteroid dependence also experienced significant reduction in asthma exacerbations. As the largest real-world evidence study on the impact of benralizumab therapy, our findings strengthen the body of evidence demonstrating the effectiveness of benralizumab in severe eosinophilic asthma.”
This study was sponsored by and conducted in collaboration with AstraZeneca.
Source: https://www.practiceupdate.com/content/aaaai-2022-real-world-analysis-confirms-benefits-of-benralizumab-for-severe-eosinophilic-asthma/132951/7/6/2