BENRALIZUMAB, a monoclonal antibody targeting eosinophilic inflammation, outperformed prednisolone alone in treating acute exacerbations of asthma and COPD in a new study. This double-blind, placebo-controlled trial suggested an alternative for patients with eosinophilic endotypes, potentially reshaping current treatment standards.
Key Findings:
• Trial Design: The ABRA study involved 158 adults experiencing acute exacerbations of asthma or COPD. Participants were randomly assigned to receive either benralizumab alone, benralizumab with prednisolone, or prednisolone alone.
• Results: After 90 days, treatment failure rates were lower in the benralizumab groups (45%) compared to the prednisolone-only group (74%). Symptom scores also improved markedly within 28 days for those on benralizumab.
• Safety: Benralizumab was well-tolerated, with no serious adverse events linked to the drug. Hyperglycemia and sinus infections were more common in the prednisolone group.
Clinical Implications:
These findings suggest that benralizumab could replace or supplement steroids in managing eosinophilic asthma and COPD flare-ups. The results underscore the potential of targeting eosinophilic inflammation directly, reducing reliance on systemic corticosteroids and their associated side effects.
Reference: Ramakrishnan S et al. Treating eosinophilic exacerbations of asthma and COPD with benralizumab (ABRA): a double-blind, double-dummy, active placebo-controlled randomised trial. Lancet Respir Med. 2024. doi: 10.1016/S2213-2600(24)00299-6. [ePub ahead of print].
