Clinical profile of comorbidities in patients with severe asthma undergoing benralizumab biologic therapy

Objective: This study aims to analyze the comorbidity profile of patients with severe asthma undergoing benralizumab therapy in a Romanian academic center, focusing on the impact of these comorbidities on disease management.

Methods: A retrospective analysis was conducted on 34 adult patients with severe asthma treated with benralizumab between 2020 and 2025 at the Pneumology Department of Mures County Clinical Hospital. Demographic, clinical, functional, and biological parameters were analyzed, including comorbidities, lung function tests, eosinophil counts, fractional exhaled nitric oxide, and Asthma Control Test scores. Non-parametric statistical tests were applied, with significance set at p<0.05.

Results: The study revealed a complex comorbidity profile. Cardiovascular diseases were most prevalent: hypertension was found in 91.2% of patients, ischemic heart disease in 47.1%, and heart failure in 17.6%. Pulmonary comorbidities included bronchiectasis (41.2%), pneumonia (82.4%), and obstructive sleep apnea (8.8%). ENT comorbidities were also frequent, with nasal polyposis in 35.3% and chronic rhinosinusitis in 32.4%. Metabolic conditions such as obesity (26.5%) and type 2 diabetes (29.4%) were common. Despite this burden, benralizumab therapy resulted in significant improvements in lung function, symptom control, and biomarkers, with eosinophil depletion, FeNO reduction, and improved ACT scores (p<0.001).

Conclusions: Patients with severe asthma treated with benralizumab present a high prevalence of cardiovascular, pulmonary, and metabolic comorbidities. Benralizumab therapy proved effective in reducing airway inflammation and improving clinical control, regardless of the comorbidity load. A multidimensional, personalized management approach remains essential for optimizing outcomes in this population.