Effectiveness of Benralizumab in Reducing Asthma and COPD Exacerbations in Patients with Severe Asthma and Concomitant COPD: Real-World Evidence from the ZEPHYR-5 Study

贝那利珠单抗在降低重度哮喘合并慢性阻塞性肺疾病患者哮喘和慢性阻塞性肺疾病急性加重方面的疗效:来自 ZEPHYR-5 研究的真实世界证据

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Abstract

PURPOSE: This real-world evidence study sought to evaluate the effectiveness of benralizumab on reducing both asthma and COPD exacerbations among patients with a diagnosis of asthma and concomitant COPD. PATIENTS AND METHODS: This study was a non-interventional, single-arm, retrospective database analysis of the MORE(2) Registry(®) and the 100% Medicare Fee-for-Service (FFS) claims databases from 2017-2022. Inclusion criteria were as follows: 1) prescription claim for benralizumab and ≥1 refill within 90 days (earliest claim=index date), 2) 12 months of database enrollment preceding (baseline) and following (follow-up) the index date, 3) medical claims with diagnoses of asthma and COPD during the baseline period, and 4) presence of ≥2 asthma exacerbations during the baseline period. Percent change in the annual rates of both asthma and COPD exacerbations were assessed from the baseline to follow-up, with paired t-tests used to examine statistically significant differences. Subgroup analyses were also conducted among the subset of patients with blood eosinophil levels, and by payer type. RESULTS: A total of 2894 patients with asthma and concomitant COPD were included. Following initiation of benralizumab, the mean (SD) number of total asthma exacerbations decreased by 39.2% (from 4.0 (2.2) to 2.4 (2.4) exacerbations/year; p < 0.001), while COPD exacerbations decreased by 45.6% (from 3.6 (2.5) to 1.9 (2.2) exacerbations/year; p < 0.001). The proportion of patients receiving systemic corticosteroids decreased by 11.4% from 100% to 88.6% (p < 0.001). Subgroup analyses revealed that patients with the highest eosinophil levels (≥ 300 eosinophils/µL) experienced the greatest reductions in asthma exacerbations (42.7%) and COPD exacerbations (50.8%; all p < 0.001). CONCLUSION: This study provides real-world evidence supporting the effectiveness of benralizumab in reducing both asthma and COPD exacerbations and decreasing reliance on corticosteroids, particularly among those with elevated eosinophil levels.

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