Fasenra (benralizumab) / AstraZeneca, Kyowa Kirin - LARVOL DELTA

Late Breaking Abstract - Eosinophil depletion unmasks distinct cytokine profiles in EGPA and severe eosinophilic asthma (ERS 2026) - "The anti-IL5R biologic benralizumab offers the first opportunity to examine this in the absence of eosinophils or the confounding effects of oral corticosteroids (OCS). Plasma cytokines from patients with EGPA (n=12) and SEA (n=13) off OCS on benralizumab was analysed using the Meso Scale Discovery platform... In the absence of eosinophils and confounding by broad immunosuppression, distinct inflammatory signatures exist for EGPA and SEA reflecting a mixed T2 / pro-inflammatory profile in EGPA and an epithelial signature in SEA."

Late-breaking abstract • Asthma • Eosinophilic Granulomatosis With Polyangiitis • Immunology • Langerhans Cell Histiocytosis • Rare Diseases • Respiratory Diseases • Vasculitis • CCL4 • CX3CL1 • CXCL8 • IFNB1 • IFNG • IL13 • IL18 • IL33 • IL4 • IL6 • TNFA • TSLP

Late Breaking Abstract - Airway microbiome dysbiosis is a predictor of failure to achieve clinical remission following benralizumab therapy (ERS 2026) - "Higher baseline Log₂ P:B was associated with lower remission rates, neutrophilic inflammation, and increased exacerbation risk in patients treated with benralizumab. Airway microbial dysbiosis and eosinophilic inflammation may act as reciprocal predictors of severe asthma outcomes to benralizumab."

Clinical • Dysbiosis • Late-breaking abstract • Asthma • Immunology • Inflammation • Respiratory Diseases

Late Breaking Abstract - Beyond the Eosinophil: Benralizumab Drives Coordinated CD4+ T Cell Immune Remodelling in Severe Eosinophilic Asthma (ERS 2026) - "Benralizumab drives coordinated CD4+ T cell immune reprogramming in the asthmatic airway that extends beyond eosinophil depletion. These changes are compartment-specific, clinically correlated and mechanistically consistent with active resolution of T2 inflammation."

Late-breaking abstract • Asthma • Immunology • Inflammation • Respiratory Diseases • CCR6 • CD4 • CRLF2 • CXCR3 • IFNG • IL13 • IL5 • TGFB1

Late Breaking Abstract - The impact of benralizumab on FeNO in severe asthma is associated with bronchial epithelial phenotype and is independent of local eosinophil depletion (ERS 2026) - "Change in FeNO with benralizumab appears independent of local eosinophil depletion and is determined by pre-existing bronchial epithelial cell identity. Our data suggests a role for mast cell associated IL-13 pathways that persist after eosinophil depletion, as well as a novel role for the neuroendocrine pathway. Planned validation in bronchial biopsies will provide histological corroboration of these transcriptomic findings."

Late-breaking abstract • Asthma • Immunology • Respiratory Diseases • IL13 • MUC5B

Late Breaking Abstract - Integrated study of miRNome and secretome profile in biologic-treated severe asthma (ERS 2026) - "Aims and objectives Characterize changes in serum microRNA expression and pro-inflammatory mediators in patients receiving mepolizumab, dupilumab, or benralizumab, during 1-year follow-up. In sputum supernatant, TGF-β1 was downregulated in benralizumab-treated patients at 1 year. Conclusions Biologic therapies in severe asthma may modulate miRNome and serum secretome over time."

IO biomarker • Late-breaking abstract • Asthma • Immunology • Respiratory Diseases • CASP8 • CCL11 • CD8 • EIF4EBP1 • IL4 • MIR183 • MIR199B • MIR494 • MIR769 • PD-L1 • TGFB1

Late Breaking Abstract - Effect of Benralizumab on airways remodeling in patients with severe eosinophilic asthma (preliminary data of the BREATH study) (ERS 2026) - P4 | "In our study, 12 months of anti-IL5R treatment in patients with severe eosinophilic asthma leads to the reduction of basement membrane thickness, airway smooth muscle area and sub-mucosal eosinophil number consistent with previous studies that have suggested the modification effect of biologic treatment in severe asthmatics with eosinophilic phenotypes."

Clinical • Late-breaking abstract • Asthma • Immunology • Respiratory Diseases

Late Breaking Abstract - Digital spacer monitoring of inhaler adherence and technique to understand treatment response in biologic-treated severe asthma (ERS 2026) - P | "Biologics included dupilumab (n=11), benralizumab (9), mepolizumab (6), tezepelumab (4), omalizumab (1), and reslizumab (1). Median TAI score (49 [IQR 48–50]), blood eosinophils (<300 cells/µL), and daily OCS use (3/32) were unchanged. Conclusion Digital spacer monitoring revealed poor and variable adherence and inhaler technique in biologic-treated severe asthma, potentially contributing to ongoing disease activity (e.g. OCS use)."

Adherence • Late-breaking abstract • Asthma • Immunology • Respiratory Diseases

Variability of Impulse Oscillometry parameters as Predictor of Severe Asthma Remission (ERS 2026) - "This prospective study included patients receiving Benralizumab (B), Dupilumab (D), Mepolizumab (M) or Omalizumab (O). Improvement in pre–post bronchodilator peripheral airway resistance measured by IOS is associated with complete remission, unlike large airway changes. Longitudinal small airway assessment offers a sensitive tool to predict remission, potentially reflecting residual peripheral inflammation that may prevent it."

Clinical • Asthma • Immunology • Inflammation • Respiratory Diseases

Remission outcomes on biologics in a multinational severe asthma cohort (ERS 2026) - "Benralizumab and dupilumab showed superiority in terms of achievement of clinical remission and FEV1>80% at one year of treatment compared to omalizumab and mepolizumab."

Clinical • Asthma • Immunology • Respiratory Diseases

Longitudinal mixed-effects analysis of treatment effects on sputum bacterial load and sputum inflammatory cell profiles in patients with eosinophilic asthma and COPD exacerbations (ERS 2026) - "Benralizumab-containing therapy was associated with a marked and time-specific reduction in sputum bacterial load. However, it did not significantly modify sputum inflammatory cell differentials. These findings suggest a primarily antimicrobial effect without detectable modulation of airway cellular inflammation."

Clinical • Inflammatory cell • Asthma • Chronic Obstructive Pulmonary Disease • Immunology • Inflammation • Respiratory Diseases

Type 2 Biologics as Steroid-Sparing Therapy in Idiopathic Chronic Eosinophilic Pneumonia: A Multicenter Study (ERS 2026) - " Forty patients were included (median age 59yo; 42% female): 25 received mepolizumab (21 at 100mg/4w, 4 at 300mg/4w), 14 benralizumab (30mg/8w), and 1 dupilumab (200mg/2w). In this multicenter iCEP cohort, mAb was associated with sustained clinical benefit and a marked steroid-sparing effect, with a favourable safety profile. Prospective confirmation is needed."

Clinical • Asthma • Cough • Eosinophilia • Immunology • Infectious Disease • Pneumonia • Rare Diseases • Respiratory Diseases

Blocking the IL4/IL-13 pathway improves airway resistance in severe asthma in real-life (ERS 2026) - " This retrospective analysis included 86 patients suffering from severe asthma initiated with different biologicals (Dupilumab (N=34), Tezepelumab (N=21), Mepolizumab (N=18), Benralizumab (N=8) and Omalizumab (N=5)) at the University of Liège, Belgium. Our study shows a significant improvement in airway resistances in both large and small airways in patients receiving Dupilumab for 6 months. The absence of impact of Dupilumab on other IOS measures and the absence of significant changes with other targeted treatments have to be confirmed in larger cohorts."

Clinical • Asthma • Immunology • Respiratory Diseases • IL13 • IL4

Using fractional exhaled nitric oxide (FeNO) to guide oral corticosteroid (OCS) use during asthma exacerbations in patients on anti-IL5/5R biologics. (ERS 2026) - "Methods Retrospective review of adults with severe asthma on mepolizumab (n=42) or benralizumab (n=69) presenting to outpatients with symptoms of AE over 12 months. Two patients in the non-OCS group required OCS within 2 weeks. Conclusion FeNO-guided assessment of AEs in patients receiving anti-IL5/5R mAbs can support targeted OCS use and reduce unnecessary OCS exposure without compromising short-term outcomes."

Clinical • Asthma • Cough • Immunology • Infectious Disease • Inflammation • Respiratory Diseases • IL5

Eosinophil Trajectories During Acute Exacerbations Treated with Prednisolone or Benralizumab: Insights from the ABRA Trial (ERS 2026) - "Prednisolone, unlike benralizumab suppresses eosinophils inconsistently following an eosinophilic exacerbation."

Asthma • Chronic Obstructive Pulmonary Disease • Immunology • Respiratory Diseases

Treatment failure following an eosinophilic exacerbation treated with Benralizumab or Prednisolone: ABRA data (ERS 2026) - "Higher FEV1% predicted at baseline and during exacerbation, as well as higher PEF % predicted during exacerbation were independently associated with reduced odds of treatment failure underscoring their role as key determinants of clinical prognosis."

Asthma • Chronic Obstructive Pulmonary Disease • Immunology • Respiratory Diseases • KEAP1

Clinical biomarker and response trajectories in severe asthma on biologic therapies: the Precision Medicine Intervention in Severe Asthma (PRISM) cohort (ERS 2026) - "Methods 167 participants with severe asthma were assessed before and at 1, 6 and 12 months after biologic treatment with Mepolizumab (M; n=48) or Benralizumab (B; n=62) or Tezepelumab (T; n=20) initiated according to NICE criteria. Blood eosinophil count trajectory varied by biologic class, with larger reductions in M and B. FeNO decreased over time with greatest fall with T, but was not associated with blood eosinophil change; eosinophil change was associated with CQA scores. Conclusion PRISM defined multi-domain remission and characterises the class-specific clinical and Type-2 biomarker trajectories at one year."

Biomarker • Clinical • Asthma • Cough • Immunology • Respiratory Diseases

Clinical remission in severe asthma after 12 months of biologic therapy: a real-life cohort study (ERS 2026) - " This monocentric, retrospective real-life study included 75 adults with severe asthma treated with mepolizumab, benralizumab, or dupilumab (October 2023–September 2025). In this real-life monocentric cohort, clinical remission was achievable in approximately half of patients with severe asthma treated with biologics. Preserved lung function, a T2-high inflammatory profile, and coexisting GERD were associated with a higher probability of remission. Larger multicentre studies are warranted."

Clinical • Asthma • Eosinophilia • Gastroenterology • Gastroesophageal Reflux Disease • Immunology • Respiratory Diseases

Remission with Benralizumab in Severe Asthma: Real-World Evidence from the French claims database (BENEFIT Study) (ERS 2026) - "In this nationwide cohort, a considerable proportion of SA patients achieved remission within 2y of initiating benralizumab and the analysis highlight several conditions associated with remission."

Claims database • Clinical • HEOR • Real-world • Real-world evidence • Asthma • Immunology • Nasal Polyps • Otorhinolaryngology • Respiratory Diseases

Clinical remission on treatment with biologic therapies for severe asthma: a three-year real-life study. (ERS 2026) - "Aims:This is a retrospective real life monocentric study.The primary endpoint is to evaluate the clinical remission after 3 years of treatment with Mepolizumab, Benralizumab and Dupilumab in patients with severe asthma.Secondary endpoints are to assess if baseline FEV1% (Forxed expiratory volume in 1 second) and RV/TLC % (Residual volume/total lung capacity) are predictive of clinical remission and if blood eosinophils at baseline can be predictive of remission in patients treated with anti IL-5 (anti interleukin-5). More than 60% of patients achieve clinical remission on treatment after three years. Higher FEV1% and lower RV/TLC% are predictive of clinical remission.Higher blood eosinphils in patients treated with Benralizumab are predictive of clinical remission."

Clinical • Asthma • Immunology • Respiratory Diseases • IL5

In-clinic and at-home administration of injectable biologics for severe asthma and CRSwNP places a considerable time burden on patients and HCPs: Pooled results from a time and motion study (ERS 2026) - "A time model included dosing frequency (dupilumab [Q2W], mepolizumab [Q4W], omalizumab [Q4W], tezepelumab [Q4W] and benralizumab [Q8W]). Injectable biologic administration was associated with considerable HCP and patient time, with higher dosing frequency driving greater in-clinic administration burden. Funding: GSK (214575)"

Clinical • Asthma • Chronic Rhinosinusitis With Nasal Polyps • Immunology • Nasal Polyps • Respiratory Diseases

Total serum IgE in severe adult-onset intrinsic asthma: relationship to eosinophil counts and anti-eosinophil treatment responses (ERS 2026) - " We analysed 80 real-world patients (59% females, 38% never-smokers) from our outpatient clinic, using these inclusion criteria: (1) severe adult-onset asthma (age of onset ≥18 years), (2) no history or presence of allergies or allergic diseases, (3) no significant specific IgE against aeroallergens, (4) no previous biologic treatment at baseline, (5) first-line treatment with Mepolizumab (n=35) or Benralizumab (n=45). Among patients with severe adult-onset intrinsic asthma, subjects with high IgE have stronger eosinophilia and better lung function than those with low IgE. However, this does not translate into stronger effects of anti-eosinophil biologics."

Clinical • Asthma • Chronic Rhinosinusitis With Nasal Polyps • Eosinophilia • Immunology • Nasal Polyps • Otorhinolaryngology • Respiratory Diseases • Sinusitis

Impact of treatment with a biologic agent on exercise capacity in patients with severe asthma (ERS 2026) - " 14 subjects (7 males, 7 females, mean age: 44,9 years) participated; 8 added benralizumab to their asthma therapy, 3 tezepelumab, 2 mepolizumab and 1 omalizumab. Adding biologic agents to controller therapy improves peak VO2 and exercise time, along with asthma control, in severe asthmatic patients within 6-9 months of administration."

Clinical • Asthma • Immunology • Pulmonary Disease • Respiratory Diseases

Sputum burden as important treatable trait for severe asthma patients on biologics (ERS 2026) - "Persistent sputum production was much more common in people treated with tezepelumab (91%) versus benralizumab (50%)(Χ2p=0.03) SA patients on benralizumab reported improved ACQ compared to tezepelumab with reduced need for antibiotics & reduced SpEo Difficulty in getting FU samples (homecare, dry chest). Difficulty in getting FU samples (homecare, dry chest). Sputum burden unmasked as a valid therapy target. These are preliminary results, as more patients go through FU, differences between responses to biologics might emerge, helping determine which parameters at baseline are best indicators of treatment response."

Clinical • Asthma • Immunology • Respiratory Diseases

BREATHE study: T2 biomarkers and treatment patterns in severe asthma patients with and without comorbid CRSwNP. (ERS 2026) - "Drug choices differed: Yes-NP used more dupilumab and mepolizumab, while No-NP used more benralizumab and omalizumab. FeNO differences were largest at -12m and diminished over time, suggesting inflammatory control after treatment optimization. CRSwNP status strongly shaped biologic choice, reinforcing its value as a precision trait for earlier targeted therapy."

Biomarker • Clinical • Asthma • Chronic Rhinosinusitis With Nasal Polyps • Eosinophilia • Immunology • Inflammation • Nasal Polyps • Respiratory Diseases

Beyond Type 2 Inflammation: How Obesity Impacts Clinical Remission in Biologic-Treated Severe Asthma (ERS 2026) - " Eighty-two SA patients prospectively enrolled and treated with biologics were included (benralizumab n=29, 35.4%; dupilumab n=30, 36.6%; mepolizumab n=16, 19.5%; tezepelumab n=7, 8.5%). Higher baseline BMI was associated with a reduced likelihood of clinical remission in biologic-treated SA, despite comparable modulation of T2 biomarkers, suggesting the involvement of non-T2 mechanisms."

Clinical • Asthma • Genetic Disorders • Immunology • Inflammation • Obesity • Respiratory Diseases