(408) Reduction in Asthma Exacerbations Following Initiation of Benralizumab Among Medicare Beneficiaries: Results from the ZEPHYR-5 Study

Background: : Benralizumab has been shown to reduce asthma exacerbations among patients with severe asthma in the clinical trial setting. However, older patients are typically underrepresented in clinical trials and retrospective studies.

Objective: : This real-world evidence study sought to evaluate the change in asthma exacerbations following initiation of benralizumab among older patients with Medicare insurance.

Methods: : Medicare Fee-for-Service (MFFS) and Medicare Advantage (MA) claims spanning 2017-2022 were utilized for this study. Inclusion criteria: 1) prescription for benralizumab and ≥1 refill within 90 days (earliest prescription=index date), 2) 12 months of enrollment with MFFS or MA benefits preceding (baseline) and following (follow-up) the index date, 3) ≥1 inpatient or ≥2 outpatient claims with a diagnosis code for asthma during the baseline period, and 4) presence of ≥2 asthma exacerbations during the baseline period. Exacerbations were assessed during the baseline and follow-up periods, and were defined as 1) an asthma-related hospitalization, 2) a mechanical ventilation claim, or 3) an outpatient or emergency department visit with an asthma diagnosis and a claim for systemic corticosteroids within seven days. Percent change in annual asthma exacerbation rate (AAER) was assessed from the baseline to follow-up.

Results: : 4,611 patients qualified for the study. The mean±SD age was 69.3±10.9, and the majority were female sex (n=3,185; 69.1%) and MFFS beneficiaries (n=4,213; 91.4%). There was a 43.5% reduction in the AAER from the baseline period to the follow-up period (3.8±2.0 to 2.2±2.2 exacerbations per year; p < 0.001). The proportion of patients with ≥4 exacerbations decreased 50.5%.

Conclusions: : Older patients with severe asthma treated with benralizumab demonstrated meaningful reductions in the rate of asthma exacerbations in a real-world setting.

Sponsorship:: AstraZeneca