TOPLINE

Treatment with benralizumab significantly reduced overall mucus burden in patients with severe eosinophilic asthma (SEA), with total mucus volume and mucus plug scores decreasing from baseline to 13 weeks. Overall, benralizumab demonstrated a favorable safety profile, with no new safety concerns or deaths noted.

METHODOLOGY

• Researchers conducted a multicenter phase 4 study between October 2022 and July 2024 to assess the changes in airway structure and function in patients with SEA following treatment with benralizumab.
• A total of 39 patients (mean age, 54.5 years; 59.0% women; 92.3% White individuals) with SEA inadequately controlled with inhaled corticosteroids and long-acting beta-2 agonists were included in the study.
• Patients received 30 mg of benralizumab subcutaneously every 4 weeks for a total of three doses, administered as a 1-mL solution in a single-use prefilled syringe.
• The primary endpoint was the change from baseline (week 0) to week 13 in total mucus volume at total lung capacity (TLC), measured using Functional Respiratory Imaging.
• Secondary endpoints included the changes from baseline to week 13 in total mucus plug scores at TLC and total lung volume at both TLC and functional residual capacity (FRC). The safety profile was also assessed.

TAKEAWAY

• Treatment with benralizumab significantly reduced total mucus volume at TLC from baseline (mean, 0.21 mL) to week 13 (mean, 0.08 mL), representing a 61% reduction (P = .033); this reduction was more pronounced in patients with four or more mucus plugs at baseline (P = .036).
• Total mucus plug scores at TLC decreased significantly from baseline to week 13 (P = .042), and changes in total mucus volume and total mucus plug scores at 13 weeks were inversely correlated with improvements in prebronchodilator forced expiratory volume in 1 second (FEV1; P < .001 for both) and forced vital capacity (FVC; P = .010 and P = .003, respectively).
• No significant correlations were observed between changes in prebronchodilator FEV1 or prebronchodilator FVC and changes in airway wall volume, airway volume at FRC, or lung volume at TLC.
• Overall, 37.8% of patients experienced at least one adverse event and 4.4% experienced serious adverse events, mainly severe respiratory infection and asthma exacerbation; however, no deaths were reported.

IN PRACTICE

“These findings align with previous observations that benralizumab significantly reduced mucus burden and improved asthma control in patients with poorly controlled eosinophilic asthma,” the authors wrote.

SOURCE

This study was led by Donna D. Carstens, MD, AstraZeneca in Wilmington, Delaware. It was published online on July 15, 2026, in Respiratory Research.

LIMITATIONS

This study had several limitations, including a short duration of 13 weeks, a small sample size, an open-label design, and a predominantly White patient population. The absence of a placebo arm was also noted as a limitation.

DISCLOSURES

AstraZeneca provided funding for this study. Four authors disclosed being employees or contractors of AstraZeneca at the time of study conduct and reporting and possibly owning stock or stock options in the company. Four other authors disclosed having ties (three as employees and one as a medical advisor) with FLUIDDA, which received funding from AstraZeneca to conduct this study.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.