Background: Viral respiratory infections are associated with asthma exacerbations, still it is uncertain if asthma patients treated with biologics are more vulnerable to SARS-Cov-2 infection. Aim: Evaluation of characteristics and outcomes of COVID-19 disease in asthma patients treated with biologics. Methods: 27 asthma clinics from Greece provided data concerning demographic and functional characteristics, as well as medical treatments of patients treated with biologics. Patients were prospectively followed up and had a PCR test for confirmation of COVID-19 disease in case of suspected symptoms. Results: 541(352 female) patients receiving biologics (omalizumab 210, mepolizumab 321 and benralizumab 9 patients, respectively), mean age 57.3±14.4 years, were studied. In total, 14(2.6%) patients (8 female), mean age 58.6 years had a confirmed SARS-Cov-2 infection. 6/14, all female, were hospitalized due to severe disease, with mean length of hospital stay 15.8 days, while 1 received mechanical ventilation and died from severe COVID-19. Five of PCR+ patients (35.7%) experienced an asthma exacerbation, defined as asthma control deterioration requiring treatment with systemic steroids, while all others had clinical and radiological manifestation of pneumonia without loss of control. Administration of biologics was performed timely, apart from 1 case in which it was delayed according to physician's decision. Conclusion: Our study confirm that COVID-19 is not more common in asthmatics treated with biologics compared to general population. However, more than a 1/3 experienced an asthma exacerbation, although in the majority infection did not result in loss of control and scheduled administration of biologics was not interrupted.
Introduction: Benralizumab is a humanized monoclonal antibody targeting the interleukin-5 receptor (IL-5a) that is expressed on eosinophils and inhibits eosinophilic inflammation. It is approved for the treatment of severe eosinophilic asthma. Aim: To evaluate the clinical experience, effectiveness and safety of benralizumab treatment to patients with severe eosinophilic asthma in Greece. Methods: A multicenter prospective observational study which was conducted in 19 different Pulmonary Centers in Greece. The recruitment period lasted 18 months and the follow-up period is 2 years. Preliminary results: 122 patients were eligible (70 women), with an average age of 56 years (min 30, max 82). 76 patients completed the 12month follow up. Significant improvement in ACT score (22±3.5 vs 15.9±4.4, p<0,01) and in FEV1 %pred (81.2±20 vs 72.4±22.2, p<0,01) was observed. There was 77,8% (p<0,001) reduction in annual exacerbation rate, while 50% of patients experienced no exacerbations during 12 months of treatment. OCS mean dosage was reduced from 10.4±6 to 5.2±2.1 mg (p<0,01) prednisolone equivalent and 70% of those treated with OCS at baseline discontinued OCS. Adverse events were experienced by 12 patients (9.8%), most commonly headache, while 4 patients withdrew from the study voluntarily and 5 discontinued the drug (2 due to urticaria, 1 due to pregnancy, 2 due to personal reasons). No serious adverse events were observed. Conclusions: Benralizumab was associated with improvement in asthma control and lung function and significant reduction in the annual rate of exacerbations and OCS use after one year of treatment.
