XALOC-1: Clinical remission over 2-years with benralizumab in severe eosinophilic asthma
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BACKGROUND: Long-term real-world data on clinical remission in patients with severe eosinophilic asthma (SEA) receiving biologics are lacking. We describe clinical remission over 2 years in patients with SEA receiving benralizumab. RESEARCH QUESTION: Is long-term clinical remission a viable goal for patients with SEA receiving benralizumab? STUDY DESIGN AND METHODS: XALOC-1 is a multinational, retrospective, real-world program in adults with SEA who received benralizumab for ≤ 96 weeks. Percentages of patients meeting the components and composite of clinical remission (no exacerbations, no maintenance oral corticosteroid use, and well-controlled asthma [Asthma Control Test score ≥ 20 or 6-item Asthma Control Questionnaire score ≤ 0.75]) were assessed at weeks 0, 48, and 96. The association between key baseline demographics, clinical characteristics, and clinical remission status was assessed at weeks 48 and 96 using multivariable logistic regression analysis. RESULTS: Of 1,070 patients, 0.4%, 39%, and 31% met the 3-component clinical remission criteria at weeks 0, 48, and 96, respectively. In biologic-naïve and biologic-experienced patients, remission occurred in 43% and 32% (week 48), and 36% and 23% (week 96), of patients, respectively. Lower maintenance oral corticosteroid dose (OR, 0.51; 95% CI, 0.34-0.76), lower BMI (OR, 0.56; 95% CI, 0.36-0.86), and higher peak eosinophil count (OR, 1.68; 95% CI, 1.05-2.69) at baseline were positively associated with meeting criteria for clinical remission at week 96. INTERPRETATION: Clinical remission is a realistic goal, sustainable up to 2 years in around one-third of patients with SEA receiving benralizumab. Remission was more likely in patients with lower baseline disease burden, suggesting that further research is warranted regarding whether earlier initiation of a biologic may be beneficial.
