{
  "abstract": "Background Prednisolone is the standard of care for treatment of exacerbations of asthma and COPD and has been shown to deplete eosinophil counts in severe asthma at stable state (Moran, AJRCCM 2020). The ABRA trial was a multicentre, phase 2, double-blind, placebo-controlled trial. Eosinophilic exacerbations (eosinophils ≥300 cells/µL) were randomised 1:1:1 to: (1) benralizumab + placebo (BENRA), (2) placebo + prednisolone (PRED), or (3) benralizumab + prednisolone (BENRA+PRED).Objective We explored the trajectory of the eosinophil count in ABRA patients who experienced early treatment failure compared to those who did not.Results Early treatment failure (treatment failure within the first 5 days), occurred in 17 (19.5%) of patients (n=4 (23%) BENRA; n=5 (29%) BENRA+PRED; n=8 (47%) PRED). The pooled BENRA group demonstrated a mean difference of -0.514 (95%CI -0.627 to -0.402; p= <0.001) in eosinophils, whereas PRED group demonstrated a mean change of -0.170 (95%CI-0.469 to 0.129, p=0.221, see figure 1) between exacerbation and day 7. Within the group of patients for whom no treatment failure occurred, eosinophils within the pooled BENRA group demonstrated a mean change of -0.646 (95%CI -0.75 to -0.54, p≤0.001) and within the prednisolone group -0.221 (95%CI -0.53 to 0.09, p=0.143).Abstract S175 Figure 1Eosinophils count in PRED group vs pooled BENRA group at exacerbation (D0) and first clinic visit (D7)Conclusion Prednisolone, unlike benralizumab had no effect on reducing eosinophil count during eosinophilic exacerbations. Whether this relates to treatment failures needs to be further elucidated.Reference Moran AM, Ramakrishnan S, Borg CA, Connolly CM, Couillard S, Mwasuku CM, Pavord ID, Hinks TSC, Lehtimäki L. Blood eosinophil depletion with mepolizumab, benralizumab, and prednisolone in eosinophilic asthma. Am J Respir Crit Care Med. 2020;202(9):1314–1316. doi: 10.1164/rccm.202003–0729LE. PMID: 32584603; PMCID: PMC7605198",
  "authors": [
    {
      "affiliations": [
        "King’s College Centre for Lung Health, King’s College London, London, UK"
      ],
      "name": "N Smallcombe"
    },
    {
      "affiliations": [
        "King’s College Centre for Lung Health, King’s College London, London, UK"
      ],
      "name": "M Zheng"
    },
    {
      "affiliations": [
        "Institute for Respiratory Health, University of Western Australia, Perth, Australia"
      ],
      "name": "S Ramakrishnan"
    },
    {
      "affiliations": [
        "King’s College Centre for Lung Health, King’s College London, London, UK"
      ],
      "name": "S Cass"
    },
    {
      "affiliations": [
        "King’s College Centre for Lung Health, King’s College London, London, UK"
      ],
      "name": "C Mwasuku"
    },
    {
      "affiliations": [
        "Nuffield Department of Medicine, University of Oxford, Oxford, UK"
      ],
      "name": "K Krassowska"
    },
    {
      "affiliations": [
        "Nuffield Department of Medicine, University of Oxford, Oxford, UK"
      ],
      "name": "L Bermejo-Sanchez"
    },
    {
      "affiliations": [
        "King’s College Centre for Lung Health, King’s College London, London, UK"
      ],
      "name": "REK Russell"
    },
    {
      "affiliations": [
        "King’s College Centre for Lung Health, King’s College London, London, UK"
      ],
      "name": "M Bafadhel"
    }
  ],
  "title": "S175 Tracking eosinophils following prednisolone or benralizumab at the time of an exacerbation in the ABRA trial",
  "uid": "282c04cd-c766-5ed6-a547-3d0c3c7c2855"
}