Efficacy of switching controlled and uncontrolled asthma patients on Mepolizumab to Benralizumab

Severe eosinophilic asthma (SEA) is a common phenotype of severe asthma. This prospective study aimed to assess the effects of switching from Mepolizumab to Benralizumab, two biologic therapies targeting the interleukin-5 (IL-5) pathway, in patients with SEA. A total of 45 patients with SEA who had been on Mepolizumab for at least 6 months were included in the study. Baseline characteristics and asthma outcomes were evaluated before and after the switch to Benralizumab. Primary outcomes included changes in exacerbation rates, maintenance oral corticosteroid (mOCS) use, lung function, asthma control, and blood eosinophil counts. Mepolizumab led to significant improvements in all asthma outcomes. After switching to Benralizumab, these improvements were maintained in patients whose asthma was controlled on Mepolizumab. In patients who were uncontrolled on Mepolizumab, switching to Benralizumab resulted in improved asthma control in 41% of cases. Notably, all patients on mOCS while on Mepolizumab were able to completely discontinue mOCS within 3 months of starting Benralizumab. This prospective study provides real-world evidence supporting the effectiveness of switching from Mepolizumab to Benralizumab in patients with SEA. The switch to Benralizumab resulted in sustained improvements in asthma outcomes. The depletion of eosinophils observed with Benralizumab may contribute to its therapeutic effect. This is the first study to investigate the stabilizing effect of Benralizumab in controlled patients who switched from Mepolizumab to Benralizumab. These findings suggest that switching to Benralizumab can be a valuable treatment option for patients who do not respond adequately to Mepolizumab.