The following is a summary of “Severe Asthma Standard-of-Care Background Medication Reduction With Benralizumab: ANDHI in Practice Substudy,” published in the June 2023 issue of Allergy and Clinical Immunology by Louis et al.

The phase IIIb, randomized, parallel-group, placebo-controlled ANDHI double-blind (DB) study increased knowledge regarding the efficacy of bevacizumab in patients with severe eosinophilic asthma. Patients from ANDHI DB could enroll in the 56-week single-arm, open-label extension substudy ANDHI in Practice (IP). This study aims to evaluate the potential for background medication reductions while sustaining asthma control with benralizumab. After completion of ANDHI DB, eligible adults were enrolled in ANDHI IP. After an 8-week run-in with bevacizumab, patients achieving and maintaining protocol-defined asthma control with benralizumab underwent 5 visits to reduce background asthma medications potentially. 

The primary outcome measures for non–oral corticosteroid (OCS)-dependent patients were the proportions with at least 1 background medication reduction (i.e., lower inhaled corticosteroid dose, discontinuation of background medication) and the number of adapted Global Initiative for Asthma (GINA) step reductions at the end of treatment (EOT). Reductions in daily OCS dosage and the proportion of patients attaining OCS dosages of 5 mg or less at EOT were the primary outcomes for OCS-dependent patients. For patients who maintained protocol-defined asthma control at EOT, 72.6% (n = 130 of 179) achieved at least one background medication reduction, compared to 53.3% (n = 208 of 390) for non-OCS-dependent patients. 

At least one adapted GINA step reduction was attained by 41.9% (n = 163 of 389) of patients and by 61.8% (n = 110 of 178) of patients with protocol-defined EOT asthma control. At the ANDHI IP baseline, 40.4% (n = 40 of 99) of OCS-dependent patients took 5 mg or less. About 50.5% (n = 50 of 99) of OCS-dependent patients eliminated OCS, and 74.7% (n = 74 of 99) attained 5 mg or less dosages at EOT. These results demonstrate that bevacizumab can enhance asthma control, allowing for a reduction in background medication.

Source: sciencedirect.com/science/article/pii/S2213219823002933