Benralizumab Noninferior to Mepolizumab for Eosinophilic Granulomatosis With Polyangiitis

FRIDAY, March 8, 2024 (HealthDay News) — For patients with eosinophilic granulomatosis with polyangiitis (EGPA) receiving standard care, benralizumab is noninferior to mepolizumab, according to a study published in the March 7 issue of the New England Journal of Medicine.

Michael E. Wechsler, M.D., from National Jewish Health in Denver, and colleagues conducted a multicenter, phase 3, noninferiority trial to examine the efficacy and safety of benralizumab as compared to mepolizumab for adults with relapsing or refractory EGPA who were receiving standard care. A total of 140 patients underwent randomization (70 to each group).

The researchers found that the adjusted percentage of patients with remission at weeks 36 and 48 was 59 and 56 percent in the benralizumab and mepolizumab groups, respectively (difference, 3 percentage points; 95 percent confidence interval, −13 to 18; P = 0.73 for superiority), indicating the noninferiority but not the superiority of benralizumab. The two groups had a similar accrued duration of remission and time to first relapse. During weeks 48 through 52, complete withdrawal of oral glucocorticoids was achieved in 41 and 26 percent of those receiving benralizumab and mepolizumab, respectively. Adverse events were reported in 90 and 96 percent of those in the benralizumab and mepolizumab groups, respectively; serious adverse events were reported in 6 and 13 percent.

“This trial showed noninferiority of benralizumab to mepolizumab for the achievement of remission at weeks 36 and 48 in patients with relapsing or refractory EGPA who were receiving standard care,” the authors write.

The study was funded by AstraZeneca, the manufacturer of benralizumab.

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