Benralizumab is effective in severe asthma with CRS, regardless of demographic and clinical basal outcomes

Abstract

Severe eosinophilic asthma (SEA) frequently coexists with chronic rhinosinusitis (CRS), with or without nasal polyps (CRSwNP/CRSsNP), exacerbating disease burden. The Sino-Nasal Outcomes Test (SNOT-22) assesses quality of life in CRS patients, but the impact of benralizumab on nasal symptoms remains controversial. This retrospective multicenter study analyzed SNOT-22 changes after 12 months of benralizumab treatment in SEA patients with comorbid CRS from the AUTOBENRA study, including data from nine Spanish hospitals. Among 121 screened SEA patients, 72 (59.5%) had CRS, with 31 providing complete SNOT-22 data pre- and posttreatment. Subjects were predominantly female (74.2%), with a mean age of 56.4 ± 13.8 years. Most (85%) had CRSwNP, 71% reported anosmia, and 67.6% had undergone functional endoscopic sinus surgery (FESS) (mean: 2.3 ± 1.7 surgeries). The baseline SNOT-22 score averaged 55.7 ± 24.6 points. After 12 months, 21 (67.7%) achieved a minimal clinically important difference (MCID; ≥12 points). Notably, anosmic subjects were more likely to achieve the MCID (82% vs 33%; P = 0.005). No significant correlations emerged between SNOT-22 improvement and demographic, clinical, or biomarker profiles. These findings suggest that benralizumab significantly improves quality of life in SEA patients with CRS, particularly those with anosmia, regardless of baseline characteristics or biomarker levels.