Benralizumab as a steroid-sparing rescue therapy in ANCA-negative eosinophilic granulomatosis with polyangiitis: real-world experience from three cases and review of the literature
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Le résumé fourni par la source
Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare small-vessel vasculitis driven by type 2 inflammation, frequently associated with severe asthma, eosinophilia, and multiorgan involvement. Despite conventional immunosuppressive therapy, many patients remain steroid-dependent or refractory. Benralizumab, an anti-IL-5 receptor monoclonal antibody inducing rapid eosinophil depletion, has emerged as a promising therapeutic option. We present a real-world case series of three patients with severe, antineutrophil cytoplasmic antibodies (ANCA)-negative EGPA treated with benralizumab. Clinical manifestations, laboratory parameters, organ involvement, eosinophil kinetics, glucocorticoid use, and treatment outcomes were retrospectively analyzed. All patients exhibited marked peripheral eosinophilia, severe asthma or respiratory involvement, and multisystem disease. Prior glucocorticoid and immunosuppressive therapy failed to achieve sustained disease control or steroid sparing. Benralizumab administration resulted in rapid, profound, and sustained eosinophil depletion in all cases. Significant clinical improvement was observed, including improved asthma control, resolution of sinonasal and cutaneous manifestations, and better quality of life. In one patient with predominant skin involvement, clinical response was evident within hours after the first dose. In another patient, complete resolution of cardiac lesions documented on cardiac MRI was observed after six months of benralizumab therapy. Glucocorticoids were discontinued in two patients and reduced to a low maintenance dose in one. No serious adverse events occurred during follow-up. This exploratory real-world case series suggests that benralizumab may represent a promising steroid-sparing therapeutic option in selected patients with severe, steroid-dependent, ANCA-negative eosinophilic EGPA. The observed rapid eosinophil depletion and early clinical improvement should be interpreted as preliminary findings requiring confirmation in larger prospective studies.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Benralizumab as a steroid-sparing rescue therapy in ANCA-negative eosinophilic granulomatosis with polyangiitis: real-world experience from three cases and review of the literature
- Date Crossref
- 17/06/2026
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Wroclaw Medical University Department of Rheumatology and Internal Medicine pays non établi dans la noticeUniversité ou école supérieure
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Jagiellonian University Department of Rheumatology and Immunology pays non établi dans la noticeUniversité ou école supérieure
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University of Physical Culture in Kraków pays non établi dans la noticeUniversité ou école supérieure
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Krakow Cardiovascular Research Institute pays non établi dans la noticeStructure de recherche
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Ministry of Interior and Administration Department of Rheumatology pays non établi dans la noticeOrganisme public
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National Medical Institute of the Ministry of Interior and Administration pays non établi dans la noticeÉtablissement de santé
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University of Rzeszów Department of Rheumatology pays non établi dans la noticeUniversité ou école supérieure
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University Hospital in Kraków Department of Rheumatology pays non établi dans la noticeUniversité ou école supérieure
Department of Rheumatology and Internal Medicine — Wroclaw Medical University, Department of Rheumatology and Immunology — Jagiellonian University et University of Physical Culture in Kraków, avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.