Novel biologic improves airway twitchiness in severe asthma

Published: November 15, 2022

In real life, airway hyperresponsiveness (AHR) refers to an exaggerated airway narrowing or “twitchiness” resulting from inhaled allergens such as pollen. AHR is a key hallmark in severe asthma and can be measured in the clinical setting using an inhaled drug called mannitol. Previous studies have shown that the advent of novel biologic drugs that reduce asthma inflammation, such as the injectable benralizumab, has led to improved outcomes in severe asthma. However, the effect of benralizumab on AHR is unknown.

In a recent article in The Journal of Allergy and Clinical Immunology (JACI), Chan et al., enrolled 21 severe asthma patients into their study after an initial screening visit. Three doses of benralizumab were given over 12 weeks before treatment was discontinued for 16 weeks.  Mannitol challenge, lung function testing, blood sampling and patient questionnaires were obtained over six study visits in total.

The research demonstrated for the first time that 12 weeks of benralizumab significantly improves mannitol AHR in patients with severe asthma. This was accompanied by significant improvements in asthma control and asthma quality of life. At 24 weeks (16 weeks after discontinuation), AHR slightly worsened although it was still significantly improved compared to before treatment initiation.

Airway inflammation plays an important role in AHR. This study shows that dampening of asthma inflammation with benralizumab was associated with improved AHR to mannitol.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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