Reliability, Satisfaction and Effectiveness of Benralizumab Home Self-Administration in Patients with Severe Eosinophilic Asthma in Real-World Practice: The Auto-Benra Study

Ismael García-Moguel,1,2 Ana Rosado,3 Aída Gómez-Cardeñosa,4,5 Mar Gandolfo-Cano,6,7 Teresa Robledo Echarren,8 Maria del Mar Moro Moro,9 Mª del Mar Reaño Martos,10 Rafael Pineda-Pineda,11 Marcela Valverde-Monge,4,5 Cristina Martin-Arriscado Arroba,12 Javier Domínguez-Ortega13 On behalf of the AIRE Group1Department of Allergy, Hospital Universitario 12 de Octubre, Madrid, Spain; 2Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; 3Department of Allergy, Hospital Universitario Fundación Alcorcón, Madrid, Spain; 4Department of Allergy, University Hospital Fundación Jiménez Díaz, Madrid, Spain; 5Centro de investigación biomédica en enfermedades respiratorias (CIBERES), Instituto Carlos III, Madrid, Spain; 6Department of Allergy, Hospital Universitario de Fuenlabrada, Madrid, Spain; 7RETIC ARADyAL, Instituto de Salud Carlos III, Madrid, Spain; 8Department of Allergy, Hospital Clinico San Carlos (HCSC), Instituto de investigación sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain; 9Department of Allergy, Complejo Hospitalario de Toledo, Toledo, Spain; 10Department of Allergy, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; 11Department of Allergy, Hospital Universitario del Sureste, Madrid, Spain; 12Research and Science Support Unit, Instituto de investigación Biomédica del Hospital Universitario 12 de Octubre I+12, Madrid, Spain; 13Department of Allergy, La Paz University Hospital, Institute for Health Research (IdiPAZ), Madrid, SpainCorrespondence: Ismael García-Moguel, Tel +34 645852229, Email Ismaelgmoguel@gmail.comIntroduction: The increase in drugs available for severe uncontrolled asthma and the lifestyle of these patients make it necessary to implement self-administration programs of these therapies at home. Benralizumab, a monoclonal antibody targeting IL5R, was authorized in Spain for poorly controlled severe eosinophilic asthma. The possibility of administration at home was approved in March 2020 in Spain. The aim of the Auto-Benra study was to evaluate the usability and satisfaction of the benralizumab prefilled syringe and autoinjector and assessing the effectivity of these devices in uncontrolled severe eosinophilic asthma (SEA) in home-self administration.Methods: This is a retrospective, observational multicenter study uncontrolled SEA patients treated with benralizumab at least with 3 doses self-administered at home before April 30, 2021. Reliability and satisfaction with benralizumab at home were evaluated with subcutaneous administration assessment questionnaire (SQAAQ) and visual analogic scales (VAS). Effectiveness was evaluated in all patients with asthma control test (ACT), Mini Asthma Quality of Life Questionnaire (MiniAQLQ), annual exacerbation rate, oral corticosteroid treatment (OCS) and asthma-related hospitalizations and emergency visits.Results: Fifty-four patients across 9 hospitals in Spain were included. The mean SQAAQ score was 6.89 (± 0.16) points. Patients and their caregivers and doctors report excellent satisfaction by VAS, with no differences between benralizumab devices used (prefilled syringe and autoinjector). Severe exacerbation rate decreased by 65% (p = 0.0007) after benralizumab treatment. ACT score improved on average 6.27 ± 5.35 points (p < 0.0001) and the mean MiniAQLQ increased up to 1.58 ± 1.47 points (p < 0.0001). Twenty-four patients were OCS-dependent and at the end of study 14 patients get complete OCS withdrawal.Conclusion: AUTO-BENRA study supports the use of benralizumab at home given the excellent results of satisfaction and usability by patients and their caregivers.Keywords: benralizumab, severe eosinophilic asthma, self-administration, severe asthma, eosinophilic asthma