Factors influencing lung function changes when inhaled corticosteroid/formoterol is reduced in patients with severe eosinophilic asthma treated with benralizumab

In SHAMAL (<ext-link>NCT04159519</ext-link>), patients (pts) with severe eosinophilic asthma controlled on benralizumab were randomised to maintain or reduce from high-dose inhaled corticosteroid (ICS)/formoterol to medium or low dose or anti-inflammatory reliever (AIR) only over 32 weeks. >90% of pts reduced ICS/formoterol and maintained asthma control. In pts who reduced (N=92), we analysed (post-hoc) baseline (BL) characteristics and maintenance treatment dose at Week (W) 32, by lung function (LF) decrease (≥10% reduction in forced expiratory volume in 1 second [FEV₁] from BL to W48), and correlations in FEV₁ and fractional exhaled nitric oxide (FeNO) at W48. Significantly more pts with LF decrease (N=26) versus without (N=66), reduced to AIR only by W32 (80.8 vs 53%; p=0.018). There were no significant differences in characteristics between groups at BL (<bold>Table</bold>). Changes from BL in FEV₁ and fold change in FeNO at W48 were weakly correlated (r_s=–0.28; p=0.008; <bold>Figure</bold>). BL characteristics were not predictive of LF decrease. Monitoring FEV₁ in pts who reduce ICS/formoterol should be considered. <fig><object-id>erj;64/suppl_68/PA5355/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <fig><object-id>erj;64/suppl_68/PA5355/F2</object-id><object-id>F2</object-id><object-id>F2</object-id><graphic></graphic></fig>