Effect of benralizumab on recurrent COPD exacerbations

Exacerbations of COPD (ECOPD) often cluster, with higher likelihood for a patient who has had an exacerbation to experience another. 20% of patients (pts) hospitalized for ECOPD are readmitted within 30 days (d) of discharge. In a post-hoc analysis of the benralizumab COPD trials, GALATHEA (NCT02138916) and TERRANOVA (NCT02155660), we compared recurrent ECOPD within 30 and 90d after the end of an initial event in the 100 mg (B) and placebo (PBO) arms in a selected population (≥300 eosinophils/µL, triple therapy, ≥3 prior exacerbations in the previous year who experienced ≥1 exacerbation following randomization). ECOPD was defined as symptomatic worsening for at least 3d with any of the following: use of systemic glucocorticoids, use of antibiotics, hospitalization or COPD-related death. A negative binomial model with treatment, study, region, and prior ECOPD was used. 145 pts (73 B, 72 PBO) were included with 14 (B) and 62 (PBO) recurrent ECOPD within 30d, and 48 (B) and 127 (PBO) within 90d (Table). The risk of experiencing recurrent ECOPD within 30d was reduced by 60% for moderate/severe (p=0.0022), 54% for moderate (p=0.0247), and 67% (p=0.1133) for severe exacerbations following B vs PBO. The overall pattern within 90d was similar, although lower reductions were observed. This analysis suggests that benralizumab 100 mg may reduce the risk of recurrent ECOPD within 30d and 90d.