Such a speculation could be extended to both upper and lower airways for our patients complaining of severe eosinophilic asthma and nasal polyposis, highly susceptible to the add-on biological therapy with benralizumab [48,49,65,66]. control test (ACT) score ( 0.05), forced expiratory volume in the first second (FEV1) ( 0.05), and blood eosinophil count ( 0.0001). Furthermore, with respect to the end of omalizumab treatment, the score of sino-nasal outcome test-22 (SNOT-22) significantly decreased after therapy with benralizumab ( 0.05). Conclusion. The results of this real-life study suggest that the pharmacologic shift from omalizumab to benralizumab can be a valuable therapeutic approach for allergic patients with severe eosinophilic asthma, not adequately controlled by anti-IgE treatment. 0.0001) (Figure 1). The decrement of asthma exacerbation frequency due to benralizumab resulted to be Bufalin statistically significant also in comparison to the pre-shift period (after treatment with omalizumab), when the mean number of exacerbations was 4.60 3.10 ( 0.01) (Figure 1). This result was paralleled by the reduction of the hospitalization rate, which decreased from the baseline value of 0.75 0.71/year to 0.15 0.36/year ( 0.01) after treatment with omalizumab (pre-shift period), and zeroed after at least one year of add-on therapy with benralizumab ( 0.001) (Figure 2). The mean number of daily SABA inhalations, used as needed rescue medications, was 0.10 0.44 after therapy with benralizumab; this value was considerably lower than those detected at baseline (2.60 1.69; 0.0001), and after add-on treatment with omalizumab (1.95 1.82; 0.001), respectively (Figure 3). It was also possible to drastically reduce OCS intake, through a progressive lowering of OCS median dosage from baseline 11.25 mg (5.00C25.00) down to 5.00 mg (0.00C12.50; not significant) after at least 12 months of add-on therapy with omalizumab, Rabbit polyclonal to BIK.The protein encoded by this gene is known to interact with cellular and viral survival-promoting proteins, such as BCL2 and the Epstein-Barr virus in order to enhance programed cell death. and to 0.00 mg (0.00C0.00) ( 0.001) after at least 12 months of add-on therapy with benralizumab, respectively (Figure 4). In particular, at baseline, 17 patients (85%) were on regular OCS treatment, who decreased to 14 (70%) after omalizumab therapy, and to 4 (20%) after benralizumab treatment, respectively. Open in a separate window Figure 1 Effects of omalizumab and benralizumab on the annual number of asthma exacerbations. Comparisons were made between baseline and omalizumab, baseline and benralizumab, and omalizumab and benralizumab, respectively. ** 0.01; **** 0.0001. Open in a separate window Figure 2 Effects of omalizumab and benralizumab on the annual number of hospitalizations for asthma exacerbations. Comparisons were made between baseline and omalizumab, baseline and benralizumab, Bufalin and omalizumab and benralizumab, respectively. ** 0.01; *** 0.001. ns: not significant. Open in a separate window Figure 3 Effects of omalizumab and benralizumab on the daily number of SABA inhalations. Comparisons were made between baseline and omalizumab, baseline and benralizumab, and omalizumab and benralizumab, respectively. *** 0.001; **** 0.0001. ns: not significant. Open in a separate window Figure 4 Effects of omalizumab and benralizumab on the daily prednisone intake. Comparisons were made between baseline and omalizumab, baseline and benralizumab, and omalizumab and benralizumab, respectively. *** 0.001. ns: not Bufalin significant. The median ACT score increased from 12.00 (7.00C15.00) at baseline to 20.00 (17.25C23.75) during treatment with benralizumab ( 0.0001) (Figure 5). A significant rise of ACT score was experienced also when comparing post-benralizumab assessment to the result obtained before switching biological therapy, characterized by a median score of 15.00 (12.25C17.00) ( 0.05). Moreover, in 9 patients also complaining of CRSwNP, the SNOT-22 score decreased from the mean baseline value of 58.44 17.87 to 53.89 15.93 after omalizumab treatment ( 0.05), and to 43.44 19.91 after benralizumab therapy ( 0.01), respectively (Figure 6). We also detected a significant difference ( 0.05) between the two SNOT-22 scores calculated after treatments with omalizumab and benralizumab, respectively (Figure 6). Open in a separate window Figure 5 Effects of omalizumab and benralizumab on ACT score. Comparisons were made between baseline and.