Real-World Effectiveness of Benralizumab Among Patients with Asthma and Concomitant Chronic Obstructive Pulmonary Disease
International Journal of Chronic Obstructive Pulmonary Disease, 2024
Approximately 60% to 80% of patients with severe asthma have eosinophilic asthma, which is characterized by worse lung function, more severe disease, and increased exacerbation rates relative to the non-eosinophilic phenotype. Chronic obstructive pulmonary disease (COPD) is a common concomitant condition among patients with asthma. The overlap of COPD and asthma in clinical practice is not well defined as patients may present clinically in a heterogeneous manner and may present with overlapping characteristics with patients with COPD (eg, history of smoking, etc). The estimated prevalence of this overlap is 27–33%. These patients with both asthma and COPD tend to experience worse outcomes than those with either disease alone. For instance, patients with asthma and COPD have more respiratory symptoms, higher risk of exacerbations and comorbidities, and worse quality of life than patients with asthma or COPD alone. These patients are also more likely to have persistent airflow obstruction and elevated eosinophil levels.
Management of asthma and concomitant COPD involves treating both underlying conditions and aims to prevent asthma and COPD exacerbations. However, there are no clear treatment recommendations for patients with both conditions because of a lack of consensus on how the overlap of these heterogeneous diseases should be defined. Additionally, this patient population has historically been excluded from clinical trials of either asthma or COPD, resulting in limited high-quality clinical evidence to guide treatment decisions.
Benralizumab is a monoclonal antibody that targets the IL-5 receptor and promotes eosinophil depletion. Benralizumab has proven to be effective in significantly reducing the rate of asthma exacerbations among patients with asthma in both clinical trials and real-world studies. However, there is limited evidence regarding the real-world outcomes of benralizumab among patients with asthma and concomitant COPD. Therefore, this study was conducted to describe the real-world effectiveness of benralizumab in reducing asthma exacerbations and COPD exacerbations among patients with asthma and concomitant COPD.
Authors
Carstens DD, Maselli DJ, Cook EE, Mu F, Chen J, Yang D, DeMartino JK , Chung Y