Benralizumab lowers COPD exacerbations in asthma, COPD at 1 year

Key takeaways:

• COPD exacerbations went down by 51% in patients with asthma and COPD 1 year after starting benralizumab.
• Patients who experienced exacerbations before treatment had larger reductions in exacerbations.

ANAHEIM, Calif — Benralizumab lowered the rate of COPD exacerbations among patients with asthma and COPD after 1 year, according to a poster presented at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting.

“Significant and consistent reductions in COPD exacerbations were observed after benralizumab initiation,” Donna Carstens, MD, senior medical director for Fasenra at AstraZeneca, said during her presentation. “This study provides new insights into the benefits of benralizumab on reducing COPD exacerbations in patients with asthma and concomitant COPD in a real-world setting.”

In a retrospective cohort study, Carstens and colleagues analyzed 1,406 patients aged 12 years or older with asthma and COPD from a claims database between November 2016 and June 2020, to determine how benralizumab (Fasenra, AstraZeneca) changes the rate of COPD exacerbations 12 months after starting treatment vs. 12 months before treatment.

Of the total cohort, 797 patients (mean age, 60.91 years; 62.4% female) had at least one COPD exacerbation before receiving benralizumab, whereas fewer patients had at least two COPD exacerbations prior to starting the treatment (n = 379; mean age, 62.07 years; 60.2% female).

The most frequent comorbidity that appeared in the overall study population was hypertension (62.2%), followed by hyperlipidemia (45.9%), mental disorders (44.2%) and allergic rhinitis (42%), according to the poster.

In the assessment of the total cohort, researchers found that the rate of COPD exacerbations dropped by 51% when comparing rates 1 year after benralizumab with rates 1 year before benralizumab (0.59 per person-year vs. 1.21 per person-year; P < .001) in any setting.

Notably, the rate of COPD exacerbations also went down 1 year after vs. before benralizumab in the inpatient setting (42% drop), ED setting (53% drop) and outpatient setting (54% drop).

Among the group of patients who experienced at least one COPD exacerbation prior to starting benralizumab, researchers observed a 60% decrease in the rate of COPD exacerbations after treatment (2.13 per person-year vs. 0.86 per person-year; P < .001) in any setting.

A slightly higher reduction in the rate of exacerbations was found in the group that experienced at least two COPD exacerbations before benralizumab treatment, at a 62% reduction (3.37 per person-year vs. 1.28 per person-year; P < .001).

Similar to the overall cohort, both groups with previous COPD exacerbations had significant declines in the rate of exacerbations 12 months after treatment in inpatient, ED and outpatient settings.

Researchers further divided patients with at least one exacerbation before receiving benralizumab based on their eosinophil level and found greater rates of decline in COPD exacerbations among those with counts of 150 cells/L or more (n = 142), at a 62% reduction, vs. those with counts of less than 150 cells/L (n = 62), who showed a 47% reduction.

Among those with counts of 300 cells/L or more (n = 96), researchers found a 68% decline in COPD exacerbations, which was larger than the 49% decline observed in the group with eosinophil levels of less than 300 cells/L (n = 108).

“This study should be interpreted in the context of a few limitations, such as the lack of a control arm to adjust for temporal changes and the inability to see any free doses of benralizumab in the claims data,” Carstens said during the presentation.