Late Breaking Abstract - Clinical Remission in Patients with Severe Eosinophilic Asthma Treated with Benralizumab over 24 Months: Post Hoc Analysis of the ANANKE Study

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Background: Clinical remission is a novel treatment goal in severe eosinophilic asthma (SEA). Benralizumab, an anti-IL-5Rα monoclonal antibody, has demonstrated efficacy in SEA, but its potential to induce clinical remission in real-life settings over extended follow-up remains underexplored. Aim: To assess clinical remission (CR) over 24 months of benralizumab treatment in patients with SEA using the Severe Asthma Network Italy (SANI) definition. Methods: This post hoc analysis of the ANANKE study included 167 Italian patients with SEA treated with benralizumab. CR, complete or partial, was evaluated at 3, 12, and 24 months based on the SANI definition: complete CR (cCR) is defined as no OCS, and the three criteria 1) absence of symptoms, 2) absence of exacerbations, and 3) stable lung function. Partial CR (pCR) is defined similarly but only requires two of the three criteria in the absence of OCS. Results: The percentage of patients who achieved CR increased over time, from 87.2% at 3 months (40.4% pCR, 46.8% cCR) to 95.0% at 12 months (17.5% pCR and 77.5% cCR), and 96.1% at 24 months (25.5% pCR, 72.6% cCR). Baseline demographics did not predict CR. Blood eosinophil counts decreased from 476.7 to 5.2 cells/μL at 24 months. Conclusion: In this real-world retrospective cohort, benralizumab induced high rates of clinical remission over 24 months. The majority of patients achieved clinical remission as early as 3 months. These results support the role of benralizumab as a disease-modifying therapy in SEA, achieving rapid and durable clinical remission, and reinforce the clinical utility of remission as a therapeutic goal.

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