Benralizumab Achieves Clinical Remission in Severe Asthma

Benralizumab was associated with high rates of clinical remission and substantial improvements in asthma control among patients with severe eosinophilic asthma, according to a real-world study. After at least 12 months of treatment, more than three-quarters of patients met a composite definition of clinical remission, with marked reductions in exacerbations, oral corticosteroid use, and blood eosinophil counts.

Severe eosinophilic asthma is characterised by persistent airway inflammation driven by eosinophils and often remains difficult to control despite high-dose inhaled therapies. Benralizumab, an anti-IL-5 receptor monoclonal antibody, depletes eosinophils and is used to reduce exacerbations in patients with severe disease.

Clinical Remission Achieved in Most Patients

Researchers conducted a retrospective, single-centre study involving 33 adults with severe eosinophilic asthma treated with benralizumab at a tertiary referral centre.

Clinical remission was defined as the absence of asthma exacerbations, no need for maintenance oral corticosteroids, well-controlled asthma symptoms, and stable or improved lung function after at least 12 months of therapy.

Overall, 75.8% of patients achieved clinical remission during the study period.

The proportion of patients with well-controlled asthma increased to 90.9%, while the percentage requiring maintenance oral corticosteroids fell significantly from 48.5% at baseline to 24.2% after treatment.

Lung Function Improved Significantly

Treatment was associated with marked improvements in pulmonary function.

Mean forced expiratory volume in one second (FEV₁) increased by 674 mL, rising from 1,514 mL at baseline to 2,188 mL after treatment. Predicted FEV₁ also improved significantly, increasing from 54.9% to 76.8%.

Asthma exacerbations fell dramatically, with the median annual rate declining from two episodes before treatment to none after one year of benralizumab.

Peripheral blood eosinophil counts were almost completely eliminated, falling from a median of 720 cells/µL to zero cells/µL, reflecting the drug’s targeted mechanism of action.

Baseline Disease Severity Influenced Outcomes

The researchers also investigated factors associated with achieving clinical remission.

Patients with fewer exacerbations before starting benralizumab were more likely to achieve remission, while higher baseline lung function was also associated with better outcomes.

These findings suggest that earlier treatment, before more advanced disease develops, may improve the likelihood of achieving optimal disease control. However, the authors note that these associations were identified through exploratory analyses and should be interpreted cautiously.

Larger Studies Needed

The authors conclude that benralizumab can deliver high rates of clinical remission in routine clinical practice, alongside significant improvements in lung function and reductions in exacerbations and corticosteroid dependence.

They note that the study’s relatively small sample size and single-centre design limit the generalisability of the findings. Larger prospective studies will be needed to confirm predictors of remission and determine which patients are most likely to achieve sustained clinical benefit from benralizumab.

Reference

Yağdıran M et al. Clinical remission and associated factors in severe eosinophilic asthma patients treated with benralizumab: a real-world study. BMC Pulm Med. 2026;DOI: 10.1186/s12890-026-04518-2.