Asthma outcomes in patients with severe eosinophilic asthma (SEA), with and without comorbid chronic rhinosinusitis with nasal polyps (CRSwNP), treated with benralizumab in the real-world XALOC-1 study

Severe asthma and CRSwNP often coexist, and a combination of both is difficult to treat. Treatment with biologics has been shown to reduce exacerbation rates in patients with severe asthma, reduce the need of surgery and improve NP outcomes in patients with CRSwNP. Benralizumab directly depletes eosinophils, key mediators of inflammation in SEA, the most common inflammatory phenotype of severe asthma. We describe outcomes in patients with SEA, with and without comorbid NP, treated with benralizumab in the XALOC-1 study programme. This integrated analysis of retrospective data from Canada, Italy, Portugal, Spain, and the UK assessed annualised exacerbation rates (AER), maintenance OCS (mOCS) use and patient-reported outcomes (PROs; 6-item Asthma Control Questionnaire [ACQ-6] or Asthma Control Test [ACT]). Overall, patients (n=1002) had a mean (SD) age of 55.4 (13.7) years and 58.6% were female. In the 31.5% (n=316) with comorbid NP (based on medical records available at treatment initiation), mean (SD) age was 54.1 (12.5) years and 50.3% were female. By Week 48, patients with and without comorbid NP experienced similar reductions in AER and patients with mOCS use, and improvements in PRO scores. In patients using mOCS at baseline, mean dosage decreased 58.2% by Week 48 in patients with comorbid NP (n=97) and 46.8% in those without (n=179). 73.0% (73/100) of patients with comorbid NP and 65.2% (133/204) of those without, experienced improvements matching or exceeding minimal clinically important differences in ACQ-6 (–0.5) or ACT (3) scores. Patients with SEA treated with benralizumab experienced substantial improvements in asthma outcomes, regardless of the presence or absence of comorbid NP.