Pneumologie 2021; 75(S 01): S38
DOI: 10.1055/s-0041-1723334
Latebreaking Abstracts 2021

OCS Reduction According to the Presence of Nasal Polyps or Atopic Status in the PONENTE Study

L G Heaney
1   Centre for Experimental Medicine, Queenʼs University Belfast, Belfast, UK
,
A Menzies-Gow
2   Royal Brompton & Harefield NHS Foundation Trust, London, UK
,
M Gurnell
3   Wellcome-Mrc Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
,
J Corren
4   David Geffen School of Medicine at Ucla and Allergy Medical Clinic Inc., Los Angeles, Ca, USA
,
E H Bel
5   Amsterdam Umc, University of Amsterdam, Amsterdam, The Netherlands
,
J Maspero
6   Fundación Cidea, Buenos Aires, Argentina
,
T Harrison
7   Nottingham Respiratory Nihr Brc, University of Nottingham, Uk; Biopharmaceuticals R&d Digital, AstraZeneca, Cambridge, UK
,
D J Jackson
8   Guyʼs Severe Asthma Center, Guyʼs & St. Thomasʼ NHS Trust, London, Uk; Asthma UK Centre, School of Immunology & Microbial Sciences, Kingʼs College London, London, UK
,
D Price
9   Observational and Pragmatic Research Institute, Singapore; Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom
,
N Lugogo
10   University of Michigan Medical Center, Ann Arbor, MI, USA
,
J Kreindler
11   Global Medical Respiratory, Biopharmaceuticals Medical, AstraZeneca, Wilmington, De; USA
,
A Burden
12   Biopharmaceuticals R&d, Late Respiratory & Immunology, Biometrics, AstraZeneca, Cambridge, UK
,
A de Giorgio Miller
13   Medical & Scientific Affairs, Biopharmaceuticals Medical, AstraZeneca, Luton, UK
,
K Padilla
14   Late Respiratory & Immunology, Biopharmaceuticals R&d, AstraZeneca, Durham, Nc, USA
,
U J Martin
15   Late Stage Development, Respiratory and Immunology Therapeutic Area, AstraZeneca, Gaithersburg, MD, USA
,
E G Garcia Gil
16   Global Medical Respiratory, Biopharmaceuticals Medical, AstraZeneca, Barcelona, Spain
› Author Affiliations

Funding: AstraZeneca
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    Rationale: Severe asthma is frequently associated with comorbidities. Nasal polyps (NP), in particular, indicate an eosinophilic phenotype and have been shown to predict an enhanced response to benralizumab in terms of asthma exacerbations and lung function. Increased serum immunoglobulin (Ig) E levels and atopy are also common in severe asthma, although they tend not to be associated with increased risk of exacerbations or predict response to biologics. Benralizumab has been shown to decrease long-term oral corticosteroid (OCS) use among patients with severe asthma, but whether the presence of comorbid NP, elevated serum IgE, or the presence of atopy impacts the degree of OCS reduction achieved with benralizumab is unknown.

    Methods: An analysis of 598 patients in the multicenter, open-label phase III b PONENTE trial was conducted to demonstrate the ability of benralizumab to eliminate or reduce the daily OCS dosage according to the presence of comorbidities before a personalized, variable OCS down-titration was initiated. Endpoints included the proportion of patients eliminating OCS use, the proportion achieving a dosage ≤ 5 mg if adrenal insufficiency was the cause of stopping the OCS taper, and the proportion achieving a dosage ≤ 5 mg regardless of the cause of stopping the OCS taper.

    Results: At baseline, 20.9% of patients had nasal polyps, the median IgE level was 130.7 (range, 1.5 – 17 840.7) IU/mL, and 47.2% were atopic with positive Phadiatop results to common aeroallergens. More patients without chronic rhinosinusitis (CRS) than with CRS achieved the endpoints. Of patients with CRS, a higher proportion of those with NP than without NP achieved the endpoints. Similar proportions of atopic and non-atopic patients, as well as of patients with different IgE levels, achieved OCS elimination or a daily dosage ≤ 5 mg. A greater proportion of atopic patients achieved OCS elimination than non-atopic patients, but no difference was observed among patients with different IgE levels.

    Conclusions: Most patients achieved elimination or lowest possible daily OCS dosage irrespective of baseline atopic status or IgE levels. Among those with CRS, more patients with NP reduced or eliminated OCS than those without NP.


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    Publication History

    Article published online:
    30 April 2021

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