AUTHOR=D'Amato Maria , Menzella Francesco , Altieri Elena , Bargagli Elena , Bracciale Pietro , Brussino Luisa , Caiaffa Maria Filomena , Canonica Giorgio Walter , Caruso Cristiano , Centanni Stefano , De Michele Fausto , Di Marco Fabiano , Pastorello Elide Anna , Pelaia Girolamo , Rogliani Paola , Romagnoli Micaela , Schino Pietro , Senna Gianenrico , Vultaggio Alessandra , Ori Alessandra , Simoni Lucia , Boarino Silvia , Vitiello Gianfranco , Aliani Maria , Del Giacco Stefano 

TITLE=Benralizumab in Patients With Severe Eosinophilic Asthma With and Without Chronic Rhinosinusitis With Nasal Polyps: An ANANKE Study post-hoc Analysis

JOURNAL=Frontiers in Allergy

VOLUME=Volume 3 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/allergy/articles/10.3389/falgy.2022.881218

DOI=10.3389/falgy.2022.881218

ISSN=2673-6101

ABSTRACT=Background: Severe eosinophilic asthma SEA) in the presence of chronic rhinosinusitis with nasal polyps (CRSwNP) indicates the presence of a more extensive eosinophilic inflammation. Post-hoc analyses from pivotal clinical trial have demonstrated the enhanced efficacy of benralizumab on asthma outcomes in patients with CRSwNP as comorbidity.  
Methods; Post-hoc analysis from the multi-center, observational, retrospective, Italian ANANKE study. Patients were divided in two groups based on self-reported CRSwNP. Baseline clinical and laboratory features in the 12 months prior to benralizumab prescription were collected. Change over time of blood eosinophils, annualized exacerbations rates (AER), asthma control, lung function, oral corticosteroids (OCS) use and benralizumab discontinuation were collected during observation period.
Results; At baseline, the 110 patients with CRSwNP were less frequently female (50.9% vs 74.2%) and obese (9.1% vs 22.6%), with higher eosinophils (605 vs 500 cells/mm3) and OCS use when compared to patients without CRSwNP. Similar reductions of AER were seen (-95.8% vs -91.5% for any exacerbation and -99.1% vs -92.2% for severe exacerbations in patients with and without CRSwNP, respectively). During benralizumab treatment, comorbid SEA+CRSwNP was associated with a lower risk of any exacerbation (p=0.0017) and severe exacerbations (p=0.025). After a mean±SD exposure of 10.3±5.0 months, half of SEA+CRSwNP patients eliminated OCS use. No discontinuation for safety reasons were recorded. 
Conclusions: This study helped to confirm the baseline clinical features that distinguish patients with and without CRSwNP being prescribed benralizumab. Numerically enhanced OCS reduction and lower exacerbation risk was observed in patients with SEA and comorbid CRSwNP treated with benralizumab.