Saturday, May 27, 2017

Oral Glucocorticoid–Sparing Effect of Benralizumab in Severe Asthma (free full text from 2017 NEJM)

Many patients with severe asthma rely on oral glucocorticoids to manage their disease. We investigated whether benralizumab, a monoclonal antibody directed against the alpha subunit of the interleukin-5 receptor that significantly reduces the incidence of asthma exacerbations, was also effective as an oral glucocorticoid–sparing therapy in patients relying on oral glucocorticoids to manage severe asthma associated with eosinophilia.
http://www.nejm.org/doi/full/10.1056/NEJMoa1703501#Top

In a 28-week randomized, controlled trial, we assessed the effects of benralizumab (at a dose of 30 mg administered subcutaneously either every 4 weeks or every 8 weeks [with the first three doses administered every 4 weeks]) versus placebo on the reduction in the oral glucocorticoid dose while asthma control was maintained in adult patients with severe asthma. The primary end point was the percentage change in the oral glucocorticoid dose from baseline to week 28. Annual asthma exacerbation rates, lung function, symptoms, and safety were assessed.

Results

Of 369 patients enrolled, 220 underwent randomization and started receiving benralizumab or placebo. The two benralizumab dosing regimens significantly reduced the median final oral glucocorticoid doses from baseline by 75%, as compared with a reduction of 25% in the oral glucocorticoid doses in the placebo group (P<0.001 for both comparisons). The odds of a reduction in the oral glucocorticoid dose were more than 4 times as high with benralizumab as with placebo. Among the secondary outcomes, benralizumab administered every 4 weeks resulted in an annual exacerbation rate that was 55% lower than the rate with placebo (marginal rate, 0.83 vs. 1.83, P=0.003), and benralizumab administered every 8 weeks resulted in an annual exacerbation rate that was 70% lower than the rate with placebo (marginal rate, 0.54 vs. 1.83, P<0.001). At 28 weeks, there was no significant effect of either benralizumab regimen on the forced expiratory volume in 1 second (FEV1), as compared with placebo. The effects on various measures of asthma symptoms were mixed, with some showing significant changes in favor of benralizumab and others not showing significant changes. Frequencies of adverse events were similar between each benralizumab group and the placebo group.
Conclusions
Benralizumab showed significant, clinically relevant benefits, as compared with placebo, on oral glucocorticoid use and exacerbation rates. These effects occurred without a sustained effect on the FEV1.
Free full text:
http://www.nejm.org/doi/full/10.1056/NEJMoa1703501#Top

2 comments:

  1. First, I want to complement this site administrator for creating this platform I frequently get cold sores(which lasts for 5-6 days on my lips and its painful both physically and mentally) .. As a bodybuilder, I basically get outbreak due to the daily pressure and heat in the body.. Recently I stumbled upon my salvation. I found a herbal remedy to cure hsv completely, in just 4weeks ..

    I got to know about Dr Utu after seeing a lady's testimony online. I reached the doctor and I ordered for herpes herbal medicine. He sent the herbs to me and I started making use of them. In just 2days, the cold sores are cleared. 4weeks after medication, I went to the hospital for test of cold sores and it was completely NEGATIVE.

    By following every prescription, i was able to cure my cold sore in less than 4weeks. 100% natural herbs no after effect.
    Note: Please do let others know if this work for you.
    The doctor's email is drutuherbalcure@gmail.com
    Note : follow all instructions accordingly..

    If you are sure that you have benefited from this African herbs be courageous to inform others.
    Thanks in advance

    ReplyDelete
  2. I started on COPD Herbal treatment from Ultimate Health Home, the treatment worked incredibly for my lungs condition. I used the herbal treatment for almost 4 months, it reversed my COPD. My severe shortness of breath, dry cough, chest tightness gradually disappeared. Reach Ultimate Health Home via their email at ultimatehealthhome@gmail.com . I can breath much better and It feels comfortable!

    ReplyDelete