Clinical remission by BMI in patients with severe eosinophilic asthma (SEA) over 1 year post benralizumab: real-world XALOC-2 programme

<bold>Background:</bold> Clinical remission is a viable goal in patients (pts) with SEA using biologics. Obesity can independently drive respiratory symptoms and potentially impact asthma control. <bold>Aim:</bold> Describe clinical remission in pts with SEA 12 months post-benralizumab initiation by baseline (BL) BMI. <bold>Methods:</bold> The XALOC-2 prospective, real-world programme includes pts with SEA treated with benralizumab in Belgium, Canada, Germany and Switzerland. This integrated analysis assessed clinical remission at Week (Wk) 0 and 56, defined as: exacerbation-free during assessment period (52-Wk BL; 56-Wk follow-up); no maintenance oral corticosteroid (mOCS) use; asthma symptom control (ACQ<1.5). <bold>Results:</bold> Of 535 pts (median age: 58 years; 49% female), 68% at BL were overweight (BMI ≥25-<30kg/m2; 34%) or obese (BMI ≥30kg/m2; 34%). At BL, 99% of pts had exacerbations, 38% had mOCS use and 90% had poorly controlled asthma. Overall, 0% (0/374) and 42% (111/262) met remission criteria at Wk 0 and 56, respectively (Fig 1A). Remission was lower in pts with obesity (30%) than with normal BMI (51%), largely due to inadequately improved asthma symptom control (Fig 1B). <bold>Conclusions:</bold> Clinical remission is a realistic goal in pts with SEA receiving benralizumab in the real-world. Pts with higher BMI were less likely to achieve symptom control as measured by ACQ and thus less likely to meet remission criteria.