PO:36:246 | Early real-world outcomes with benralizumab in eosinophilic granulomatosis with polyangiitis: a monocentric retrospective

Richard Borrelli¹, Stefania Nicola¹, Federica Corradi¹, Iuliana Badiu¹, Marzia Boem¹, Valentina Marmora¹, Simone Negrini¹, Luisa Brussino¹. | ¹SCDU Immunologia e Allergologia, AO Mauriziano, Dipartimento di Scienze Mediche, Università degli Studi di Torino, Torino, Italy.

Abstract

Background. Eosinophilic Granulomatosis with Polyangiitis (EGPA) is a rare small-vessel vasculitis driven by eosinophilic inflammation. Benralizumab, an IL-5 receptor antagonist, has recently been introduced for EGPA treatment, although data from real-life clinical practice following its European approval remain limited. This study aimed to assess the early effectiveness and safety of Benralizumab in patients with EGPA during the first 6 months of therapy.

Materials and Methods. Patients with EGPA were enrolled according to the 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology Classification Criteria. Blood eosinophil counts and clinical manifestations were recorded at baseline, after three months (T3), and at six months (T6). Changes in continuous variables were analyzed using the Wilcoxon signed-rank test.

Results. Thirteen patients (F: 66.7%) were included. No relapses were observed during the 6-month follow-up (mean relapse count: 0.0). The mean blood eosinophil count significantly decreased from baseline to T3 and T6 (mean reduction: 984.2 cells/mm³; p < 0.001; figure 1). Clinical improvement was observed across several domains. ENT symptoms, present at baseline, resolved in all affected patients. Renal involvement showed improvement (p = 0.0316), while neurological involvement remained unchanged (p = 0.157). No adverse events or treatment discontinuations were reported.

Conclusions. In this early monocentric real-world experience, Benralizumab was associated with a favorable safety profile, significant eosinophil depletion, and clinical improvement—particularly in ENT and renal involvement. Although limited by small sample size and short follow-up, these preliminary findings support the potential role of Benralizumab as a therapeutic option in EGPA, especially in patients with prominent eosinophilic or upper airway manifestations.

Keywords

• EGPA
• Benralizumab
• Vasculitis