Benralizumab for severe asthma associated with extra-airway eosinophilic diseases

Method: Asthma-associated extra-airway eosinophilic diseases such as eosinophilic pneumonia and eosinophilic otitis media usually require systemic corticosteroid therapy, and relapse is common after treatment has ceased. Aims and Objectives: To investigate the usefulness of benralizumab in the treatment of severe asthma associated with extra-airway eosinophilic diseases, we conducted a retrospective study. Methods: A review of medical records of severe asthma patients who had extra-airway eosinophilic diseases and received benralizumab treatment was performed. Results: Subjects included one male and seven females with mean age of 75.8 years-old. Eosinophilic sinusitis, eosinophilic pneumonia, eosinophilic otitis media, eosinophilic gastroenteritis, and allergic bronchopulmonary aspergillosis were seen in seven, six, three, one, one of eight patients, respectively. Six patients required chronic low-dose systemic corticosteroid therapy because of frequent relapse of extra-airway eosinophilic diseases and asthma exacerbation. Asthma control test score and peripheral eosinophilia improved significantly after the initiation of benralizumab treatment. Benralizumab treatment significantly reduced the frequency of asthma exacerbation and relapse of extra-bronchial eosinophilic diseases, and all six patients who had been taking chronic low-dose systemic corticosteroid treatment could withdraw from such treatment without exacerbation of asthma and relapse of extra-airway eosinophilic diseases. Conclusion: Benralizumab is useful in the treatment of severe asthma associated with extra-airway eosinophilic diseases.