Rapid onset of effect of benralizumab in a severe eosinophilic and allergic asthma patient with allergic bronchopulmonary aspergillosis

• Published in: Respirology case reports Vol. 11; no. 6; pp. e01167 - n/a
• Main Authors: Alaga, Arvindran, Ashraff, Khairil, Din Khan, Nurul Hana
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.06.2023; John Wiley & Sons, Inc; Wiley
• Subjects: allergic asthma; allergic bronchopulmonary aspergillosis; Aspergillosis; Asthma; benralizumab; Case Report; Case Reports; Conflicts of interest; Dyspnea; eosinophilic asthma; Fungal infections; Patients; Spirometry; Tomography; Malaysia; case report; allergic bronchopulmonary aspergillosis; allergic asthma; benralizumab; eosinophilic asthma
• ISSN: 2051-3380; 2051-3380
• DOI: 10.1002/rcr2.1167

There is limited data on the use of benralizumab in patients with severe asthma, who have allergic bronchopulmonary aspergillosis (ABPA). We report the case of a 65‐year‐old woman with combined severe eosinophilic and allergic asthma, who presented with refractory respiratory symptoms, hypereosinophilia and high immunoglobulin E (IgE) level. The patient had consistently poor Asthma Control Test (ACT) scores, despite a maximum dose of inhalation therapy. Upon further investigations, she was diagnosed with concomitant ABPA. The patient was started on oral prednisolone and itraconazole, but her symptoms persisted. She was then started on subcutaneous omalizumab, but switched to benralizumab after developing a severe allergic reaction. The patient experienced rapid clinical improvements after the first dose of subcutaneous benralizumab. Benralizumab demonstrated a significant role in reducing the exacerbation rate and oral corticosteroid use in this patient, as well as improving lung function, asthma control, and quality of life measures. Case report of a 65‐year‐old woman with combined severe eosinophilic and allergic asthma, who was later diagnosed with concomitant allergic bronchopulmonary aspergillosis. Benralizumab demonstrated a significant role in reducing the exacerbation rate and oral corticosteroid use in this patient, as well as improving lung function, asthma control, and quality of life measures.