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Benralizumab Reduces Severe Asthma Exacerbations in Older Adults, with Muhammad Adrish, MD
A real-world study shows benralizumab significantly reduced severe asthma exacerbations in older adults, with a 43.5% decrease in annual rates.
ZEPHYR-5, a real-world evidence study, showed that older adults with severe asthma experienced meaningful reductions in the rate of asthma exacerbations on benralizumab.
“This particular study was aimed to actually see what happens with this drug when it's given to patients who are old,” lead investigator Muhammad Adrish, MD, from Baylor College of Medicine, told HCPLive following his presentation at the 2025 American Academy of Allergy, Asthma, & Immunology (AAAAI) annual meeting in San Diego on March 3.
Adrish and colleagues sought to assess the change in asthma exacerbations following the initiation of benralizumab among older adults. Older adults are often underrepresented in asthma clinical trials, with the focus on younger individuals.
“Asthma is relatively considered a disease of young patients,” Adrish explained. “As the overall median age in [the] US is increasing…we expect to see more and more older patients with asthma.”
ZEPHYR-5 included 5611 patients with a mean age of 69.3±10.9 years. Participants were included if they had a prescription for benralizumab and ≥ 1 refill within 90 days, 12 months of enrollment with Medicare Fee-for-Service or Medicare Advantage with benefits lasting before and after the index date, ≥ 1 inpatient or ≥ 2 outpatient claims with a diagnosis code for asthma, and ≥ 2 asthma exacerbations. Most participants were females (69.1%) and Medicare fee-for-free beneficiaries (91.4%).
Investigators evaluated for exacerbations during the baseline and follow-up periods, which were defined as either an asthma-related hospitalization, a mechanical ventilation claim, or an outpatient or emergency department visit with an asthma diagnosis and a claim for systemic corticosteroids within 7 days. The team also assessed the percent change in annual asthma exacerbation rate from baseline to follow-up.
Benralizumab led to a 43.5% reduction in the annual asthma exacerbation rate from baseline to follow-up in older adults (3.8±2.0 to 2.2±2.2 exacerbations per year; P < .001). Moreover, the proportion of patients with ≥ 4 exacerbations were reduced by 50.5%.
“It was very important for me to know that in this particular age group, this drug is also very effective,” Adrish said. “No matter how many exacerbations they had to begin with, whether they had 2 exacerbations, 3 exacerbations, or 4 exacerbations… the beneficial effect of [the] drug was seen across the spectrum.”
A relevant disclosure for Adrish includes Astrazeneca Pharmaceuticals.
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