Efficacy and steroid-sparing effect of benralizumab: has it an advantage over its competitors?

Article Details

Authors
Francesco Menzella MD, Mirella Biava Msc, Diego Bagnasco MD, PhD, Carla Galeone Msc, Anna Simonazzi MD, Patrizia Ruggiero Msc, Nicola Facciolongo MD

Article Type
Review

DOI
10.7573/dic.212580

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Abstract

Severe refractory asthma is characterized by a higher risk of asthma-related symptoms, morbidities, and exacerbations. This disease also determines much greater healthcare costs and deterioration in health-related quality of life (HR-QoL). Another concern, which is currently much discussed, is the high percentage of patients needing regular use of oral corticosteroids (OCS), which can lead to several systemic side effects. Airway eosinophilia is present in the majority of asthmatic patients, and elevated levels of blood and sputum eosinophils are associated with worse control of asthma. Regarding severe refractory eosinophilic asthma, interleukin-5 (IL-5) plays a fundamental role in the inflammatory response, due to the profound effect on eosinophils biology. The advent of the biological therapies provided an effective strategy, even if the increased number of molecules with different targets raised the challenge of choosing the right therapy and avoid overlapping. When considering severe refractory eosinophilic asthma and anti-IL-5 treatments, it is not easy to define which drug to choose between mepolizumab, reslizumab, and benralizumab. In this article, we carried out an indirect comparison among literature data, especially between OCS reduction studies (ZONDA-SIRIUS) and pivotal studies (SIROCCO-MENSA), evaluating whether the clinical efficacy and the steroid-sparing effect of benralizumab may represent an advantage over other compounds. This data could help the clinician in the decision process of treatment choice, within the different available therapeutic options for eosinophilic refractory severe asthma.

Keywords: comparison, eosinophils, oral corticosteroids, randomized clinical trials, side effects, steroid-sparing effect.

Citation: Menzella F, Biava M, Bagnasco D, Galeone C, Simonazzi A, Ruggiero P, Facciolongo N. Efficacy and steroid-sparing effect of benralizumab: has it an advantage over its competitors? Drugs in Context 2019; 8: 212580. DOI: 10.7573/dic.212580

Contributions: All authors contributed equally to the preparation of this article. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: The authors declare that there is no conflict of interest in preparing this article. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors are available for download at https://www.drugsincontext.com/wp-content/uploads/2019/03/dic.212580-COI.pdf

Acknowledgements: None.

Funding declaration: There was no funding associated with the preparation of this article.

Copyright: Copyright © 2019 Menzella F, Biava M, Bagnasco D, Galeone C, Simonazzi A, Ruggiero P, Facciolongo N. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2019 Menzella F, Biava M, Bagnasco D, Galeone C, Simonazzi A, Ruggiero P, Facciolongo N. https://doi.org/10.7573/dic.212580. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/efficacy-and-steroid-sparing-effect-of-benralizumab:-has-it-an-advantage-over-its-competitors?

Correspondence: Francesco Menzella, Department of Medical Specialties, Pneumology Unit, Azienda USL di Reggio Emilia – IRCCS, Viale Amendola 2, 42122 Reggio Emilia, Italy. francesco.menzella@ausl.re.it

Provenance: invited; externally peer reviewed.

Submitted: 1 February 2019; Peer review comments to author: 11 March 2019; Revised manuscript received: 12 March 2019; Accepted: 14 March 2019; Publication date: 15 April 2019.

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