@article{Logan:2026:10.1016/S2213-2600(26)00096-2,
author = {Logan, J and Martin, K and Gillespie, L and McConnachie, A and Lee, W-TN and Burhan, H and Brown, T and Faruqi, S and Jackson, DJ and Kurukulaaratchy, R and Mansur, AH and Saralaya, D and Fowler, SJ and Patel, P and Brown, J and Lordan, J and Siddiqui, S and Smith, SJ and Shah, PA and Haldar, K and Megremis, S and Harrison, SA and Brown, R and Nelson, C and Mistry, V and Brown, V and Chalmers, JD and Djukanovic, R and Pavord, ID and Heaney, LG and Brightling, CE and Chaudhuri, R},
doi = {10.1016/S2213-2600(26)00096-2},
journal = {Lancet Respir Med},
title = {Asthma exacerbation profile of benralizumab for severe eosinophilic asthma (the BenRex study): a multicentre, prospective cohort study.},
url = {http://dx.doi.org/10.1016/S2213-2600(26)00096-2},
year = {2026}
}

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TY  - JOUR
AB  - BACKGROUND: Benralizumab, an interleukin-5 receptor α antagonist, depletes blood eosinophils, reducing exacerbations of severe asthma by approximately 50% versus placebo. In this study, we aimed to characterise mechanisms underlying exacerbations occurring on benralizumab. METHODS: BenRex, a multicentre, prospective cohort study, recruited participants meeting national licensing criteria for benralizumab for asthma. The study was conducted in 15 UK severe asthma centres. After collecting baseline data, open-label benralizumab was administered for 12-18 months. At exacerbation, participants attended for medical review before initiating treatment, fractional exhaled nitric oxide (FeNO), spirometry, asthma control questionnaire, and blood and sputum sampling. FINDINGS: Between Sept 30, 2019, and April 23, 2024, 121 exacerbation events were assessed in 156 individuals. 90 participants (58%) were female and 66 (42%) were male; 147 (94%) of participants identified as White. Median blood eosinophil counts at exacerbation were 0 (IQR 0-0) cells per μL. Airway neutrophilia was present in 55% of exacerbations where sputum was available (27/49). Median C-reactive protein (CRP) increased from 3·00 mg/L (1·00-6·00) at baseline to 9·00 mg/L (3·00-17·00) at exacerbation (p=0·0067). Clinically relevant viral pathogens were seen in eight (20·5%) of 39 sputum samples; although viruses were detected in 22 (56·4%) of 39 samples. Influenza A, metapneumovirus, and rhinovirus were the most common viral pathogens (each found in 2 [5·1%] of 39 samples). New acquisition of Moraxella catarrhalis (3 [13·6%] of 22), Haemophilus influenzae (4 [18·2%] of 22), and Streptococcus pneumoniae (2 [9·1%] of 22) occurred. DNA-neutrophil elastase complexes (p=0·0080) and azurocidin-1 (p=0·012) concentrations rose from baseline to exacerbation. FeNO was ≥50 parts per billion in 56 (50·
AU  - Logan,J
AU  - Martin,K
AU  - Gillespie,L
AU  - McConnachie,A
AU  - Lee,W-TN
AU  - Burhan,H
AU  - Brown,T
AU  - Faruqi,S
AU  - Jackson,DJ
AU  - Kurukulaaratchy,R
AU  - Mansur,AH
AU  - Saralaya,D
AU  - Fowler,SJ
AU  - Patel,P
AU  - Brown,J
AU  - Lordan,J
AU  - Siddiqui,S
AU  - Smith,SJ
AU  - Shah,PA
AU  - Haldar,K
AU  - Megremis,S
AU  - Harrison,SA
AU  - Brown,R
AU  - Nelson,C
AU  - Mistry,V
AU  - Brown,V
AU  - Chalmers,JD
AU  - Djukanovic,R
AU  - Pavord,ID
AU  - Heaney,LG
AU  - Brightling,CE
AU  - Chaudhuri,R
DO  - 10.1016/S2213-2600(26)00096-2
PY  - 2026///
TI  - Asthma exacerbation profile of benralizumab for severe eosinophilic asthma (the BenRex study): a multicentre, prospective cohort study.
T2  - Lancet Respir Med
UR  - http://dx.doi.org/10.1016/S2213-2600(26)00096-2
UR  - https://www.ncbi.nlm.nih.gov/pubmed/42214402
ER  - 

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