Benralizumab boosts eosinophil reduction in eosinophilic esophagitis

A recent randomized, double-blind study by Marc E Rothenberg and colleagues explored whether Benralizumab, an eosinophil-depleting anti-interleukin-5 receptor 𝛼 monoclonal antibody could provide relief for eosinophilic esophagitis. In this phase 3 placebo-controlled study, 211 patients aged 12 to 65 with active eosinophilic esophagitis were randomly assigned to receive either 30 mg Benralizumab (n=104) or a placebo (n=107) every 4 weeks.

The trial assessed histologic response (≤ 6 eosinophils per high-power field) and alteration in dysphagia symptoms using the Dysphagia Symptom Questionnaire (DSQ) after 24 weeks. After 24 weeks, 87.4% of patients on Benralizumab achieved a histologic response, compared to only 6.5% on placebo as shown in Figure 1 below.

Additionally, changes in DSQ scores, indicating dysphagia severity, were not significantly different between the two groups, as observed in Graph 1 below.

However, there were no substantial differences in the eosinophilic esophagitis endoscopic reference scores between the groups. Adverse events were experienced by 64.1% of participants in the Benralizumab group and 61.7% in the placebo group. To sum up, Benralizumab significantly reduced eosinophil levels in eosinophilic esophagitis-affected patients but did not considerably alleviate dysphagia symptoms compared to placebo.