Efficacy and safety of eosinophil-depleting therapy with Benralizumab in chronic eosinophilic pneumonia

<bold>Background:</bold> Chronic Eosinophilic pneumonia (CEP) is an idiopathic condition characterized by an abnormal accumulation of eosinophils in the lungs. The diagnosis is based on clinical, radiological findings and the presence of elevated eosinophils in BAL and in peripheral blood. Most patients are middle aged, approximatly 60% have asthma and respond rapidly to high corticosteroids doses. The disease tends to recur frequently after discontinuation of steroid treatment (75%), thus requiring chronic corticosteroid therapy or immunosuppresants. <bold>Objective:</bold> To administer Benralizumab, a monoclonal antibody against IL5-receptor, who determines a significant depleting in eosinophils as efficacy therapy in CEP. <bold>Methods:</bold> We enrolled 8 patients with CEP referring to the Rare Lung Disease Unit of Modena. At the discontinuation of corticosteroid therapy and worsening of respiratory symptoms we diagnosed asthma with bronchial reversibility on pulmonary function tests, therefore, considering an increasing level of blood eosinophils we could administer Benralizumab. We collected data about radiology, symptoms and blood tests. <bold>Results:</bold> After the administration of Benralizumab the patients showed a clinical and radiological improvement and normalization of blood tests (eosinophils, PCR), that allowed the discontinuation of corticosteroids with no side effects. <bold>Conclusions:</bold> In these cases of CEP, we tried to establish a diagnosis of severe asthma in order to permit the administration of eosinophil-depleting therapy. Considering the frequent relapses of CEP, the important side effects of corticosteroid and immunosuppressive long term therapy, Benralizumab could be a valid alternative therapy in CEP patients.