EGPA: Benralizumab or Mepolizumab Save

A multicenter, double-blind, phase 3, randomized, active-controlled trial has shown that Benralizumab (BEN) was noninferior to mepolizumab (MEP) for the induction of remission of patients with relapsing or refractory Eosinophilic granulomatosis with polyangiitis (EGPA).

Adults with relapsing or refractory EGPA on standard care therapy were randomized to either benralizumab (30 mg) or mepolizumab (300 mg) subcutaneously every 4 weeks for 52 weeks. The primary end point was remission at weeks 36 and 48.

A total of 140 patients were treated and remission at weeks 36 and 48 was 59% in the benralizumab group and 56% in the mepolizumab group (P=0.73), showing noninferiority.  While the duration of remission was similar in the two groups, complete steroid withdrawal (weeks 48 through 52) was more achieved benralizumab (41%) vs. mepolizumab (26%). Serious dverse events were reported in 6% and 13%, respectively.

It appears that the use of an interleukin-5α receptor antibody therapy is effective in treating EGPA.