Asthma remission in patients with eosinophilic granulomatosis with polyangiitis (EGPA) following treatment with benralizumab or mepolizumab

<bold>Introduction:</bold> EGPA is an inflammatory disorder featuring asthma, eosinophilia, and vasculitis. This exploratory post-hoc analysis assessed whether patients with EGPA from the MANDARA study can achieve asthma remission. <bold>Methods:</bold> MANDARA was a Phase 3, randomised, 52-week double-blind study (<ext-link>NCT04157348</ext-link>) of benralizumab 1×30 mg (n=70) vs mepolizumab 3×100 mg (n=70) SC Q4W in patients with EGPA. All patients had asthma, eosinophilia and oral glucocorticoid (OGC) dose ≥7.5 mg/day ± immunosuppressants. Asthma remission (3-component) was defined as no asthma relapse during the 52-week period, OGC=0 mg/day and an Asthma Control Questionnaire (ACQ-6) score of <1.5 (both were a 4-weekly average, at Weeks 49–52); a 4-component definition also included no worsening in FEV1 (change from baseline to Week 52 >–10%). <bold>Results:</bold> Patients had a mean (SD) age of 52.3 (14.1) years and 60.0% were women. The adjusted 3-component asthma remission rate was 33.6% and 22.3% for the benralizumab and mepolizumab groups respectively (difference: 11.25%; 95% CI: –3.19, 25.70; p=0.127; Figure). More benralizumab- than mepolizumab-treated patients achieved the 4-component remission (28.0% vs 12.4%; difference: 15.64%; 95% CI: 2.96, 28.32; p=0.016). <bold>Conclusion:</bold> Asthma remission is achievable in patients with EGPA after treatment with benralizumab or mepolizumab. <fig><object-id>erj;64/suppl_68/PA5364/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>