A Real World Study to Capture Clinical and Patient Centered Outcomes in Adults With Severe Eosinophilic Asthma Treated With Benralizumab. (EMPOWAIR)

A Real World Multicenter 48 Week Prospective Cohort Study to Capture Clinical and Patient Centered Outcomes in Adults With Severe Eosinophilic Asthma Treated With Benralizumab in Routine Care Settings in Greece

Severe eosinophilic asthma (SEA) is associated with poor disease control and compromised health-related quality of life (HRQoL), leading to a substantial psychosocial and economic disease burden. Benralizumab (Fasenra®), an interleukin (IL)-5-alpha receptor monoclonal antibody, is approved as an add-on maintenance treatment for SEA.

This study aims at collecting real-world data that extend beyond the clinical effectiveness of benralizumab to the participant-reported impact of treatment on their HRQoL, sleep quality, depression, anxiety, work productivity and activity impairment, but also on treatment effectiveness. Recent technological advances in portable spirometers and wearable activity trackers (WAT) to increase physical activity for participants with asthma, even for older participants, allow this study to collect data on lung function parameters and physical activity from such devices for the first time at a country level in Greece. Using a multi-aspect approach, this study will generate real-world evidence on a broad range of both well-established clinical and novel patient-centered outcomes which are critical to the assessment of the therapeutic benefit both from the physician's and the participant's perspective. All main study outcomes will be examined at various timepoints throughout the course of the 48-week observation period, starting as early as 4 weeks after treatment initiation, thus enabling the identification of 'early' treatment responders with a closer focus on patients' physical and psychological well-being and HRQoL in addition to asthma control and lung function metrics

Study Overview

• Status: Completed
• Conditions: Severe Eosinophilic Asthma
• Intervention / Treatment: Drug: Cohort

• Study Type: Observational
• Enrollment (Actual): 152

Contacts and Locations

Study Locations

• Greece
  • Alexandroupoli, Greece, 68100
    • Research Site
  • Athens, Greece, 11527
    • Research Site
  • Athens, Greece, 12462
    • Research Site
  • Athens, Greece, 11521
    • Research Site
  • Athens, Greece, 15125
    • Research Site
  • Athens, Greece, 17562
    • Research Site
  • Corfu, Greece, 49100
    • Research Site
  • Heraklion, Greece, 71500
    • Research Site
  • Ioannina, Greece, 45500
    • Research Site
  • Rio, Greece, 26504
    • Research Site
  • Thessaloniki, Greece, 57010
    • Research Site
  • Thessaloniki, Greece, 56429
    • Research Site
  • Thessaloniki, Greece, 55535
    • Research Site

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Private practices and hospital clinics specializing in the management of asthma in geographically diverse locations throughout Greece

Description

Inclusion Criteria:

• Male or female outpatients aged 18 to 75 years (inclusive) at the time of benralizumab prescription
• Patients with physician-diagnosed Severe Eosinophilic Asthma SEA inadequately controlled despite high-dose inhaled corticosteroids (ICS) plus long-acting β-agonists (LABA)
• Patients who have been prescribed but not yet initiated treatment with benralizumab according to the Summary of Product Characteristics (SmPC), prior to signed Informed Consent, and for whom the decision to prescribe this therapy is clearly separated from the physician's decision to include the patient in the current study
• For patients that are not Oral Corticosteroid (OCS)-dependent: Blood eosinophil count (BEC) ≥150 cells/μL in the 2 weeks before benralizumab initiation and a historical value of ≥300 cells/μL during the previous year
• For OCS-dependent patients: BEC ≥150 cells/μL in the 2 weeks before benralizumab initiation or a historical value of ≥300 cells/μL during the previous year
• History of ≥1 documented Clinically Significant Exacerbations (CSE) in the 48 weeks prior to benralizumab initiation, and of ≥2 CSEs in the previous 24 months
• Patients must be willing and able to read and complete the study specific questionnaires
• Patients must be willing and able to use the study-specific wearable/handheld devices.

Note: This requirement applies only at the time of benralizumab (Fasenra®) prescription. If a patient stops using any or both of the aforementioned devices for any reason during his/her participation in the study, (s)he may continue participating in the study and this will not be considered as a reason for withdrawal.

-Patients must provide a written Informed Consent prior to inclusion to the study

Exclusion Criteria:

• Patients that meet any of the contraindications to the administration of the benralizumab outlined in the SmPC
• Concomitant treatment with any other biologic agent for any indication
• Previous exposure to anti-IL5/ILR5 treatment
• Exposure to omalizumab in the past 6 months prior to benralizumab initiation
• Clinically important pulmonary disease other than asthma or ever been diagnosed with any disease, other than asthma, that is associated with elevated BEC
• Acute upper or lower respiratory infections within 8 weeks prior to the date of informed consent
• Heavy smokers with a >20 pack-year smoking history
• Currently pregnant (or intention to become pregnant within the study period), breastfeeding or lactating women
• Known evidence of lack of adherence to asthma controller medications
• Use of immunosuppressive medication (including but not limited to: OCS [for reasons other than asthma], methotrexate, troleandomycin, cyclosporine, azathioprine, intramuscular long-acting depot corticosteroids [for reasons other than asthma] or any experimental anti-inflammatory therapy) within 3 months prior to the date of informed consent
• Patients who currently receive treatment with any investigational drug/device/intervention or who have received any investigational product within 30 days or 5 half-lives of the investigational agent (whichever is longer) before benralizumab initiation

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in St. George's Respiratory Questionnaire (SGRQ)	Estimation of the proportion of patients achieving a minimum clinically important improvement in respiratory health status (≥ 4-point reduction from baseline in SGRQ total score) in SEA patients initiated on benralizumab	16 weeks after the initiation of the treatment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in St. George's Respiratory Questionnaire (SGRQ)	Estimation of the proportion of patients achieving a moderately efficacious change in respiratory health status (≥ 8-point reduction from baseline in SGRQ total score)	16 weeks after the initiation of the treatment
Change in St. George's Respiratory Questionnaire (SGRQ)	Estimation of the proportion of patients achieving a minimum clinically important improvement (≥ 4-point reduction in baseline SGRQ total score) and of those achieving a moderately efficacious change in respiratory health status (≥ 8-point reduction in baseline SGRQ total score)	after 4, 8, 32 and 48 weeks of treatment
Change in St. George's Respiratory Questionnaire (SGRQ)	Determination of predictors of early clinically important improvement in respiratory health status (measured by the SGRQ) at 4 weeks of treatment with benralizumab, and at 48 weeks post-benralizumab initiation among the 4-week SGRQ responders	after 4 and 48 weeks of treatment
Change in ACQ-6	Change in asthma control and the response rate as well as the response rate at 48 weeks post-benralizumab initiation among the 16-week ACQ-6 responders	after 4, 8, 16, 32, and 48 weeks of treatment
Change in the annual rate of clinically significant exacerbations	Change in the annual rate of clinically significant exacerbations (CSE) and identification of factors influencing the CSE rate	between the 48-week periods pre- and post-benralizumab initiation
change in asthma-related hospital-based health care resource utilization (HCRU)	Change in asthma-related hospital-based health care resource utilization (HCRU)	between the 48-week periods pre- and post-benralizumab initiation
Change from baseline in clinic-measured spirometric lung function indices	Change from baseline in clinic-measured spirometric lung function indices and description of the FEV1 improvement rate at 48 weeks post-benralizumab initiation among patients who will achieve clinically meaningful improvement in FEV1 at 16 weeks post-benralizumab initiation	after 16 and 48 weeks of benralizumab treatment
change from baseline in rescue medication use and in the proportion of nights with awakenings due to asthma requiring rescue medication use	Change from baseline in rescue medication use and in the proportion of nights with awakenings due to asthma requiring rescue medication use	after 4, 8, 16, 32 and 48 weeks of treatment
change in cumulative oral corticosteroid (OCS) burden	Change in cumulative oral corticosteroid (OCS) burden	etween the 16-week periods pre- and post-benralizumab initiation and the 48-week periods pre- and post-benralizumab initiation
change from baseline in anxiety and depression levels [assessed by the Hospital Anxiety and Depression Scale (HADS)]	Change from baseline in anxiety and depression levels [assessed by the Hospital Anxiety and Depression Scale (HADS)]	after 16 and 48 weeks of treatment
change from baseline in patient-reported sleep quality [assessed by the Pittsburgh Sleep Quality Index (PSQI)]	Change from baseline in patient-reported sleep quality [assessed by the Pittsburgh Sleep Quality Index (PSQI)]	after 16 and 48 weeks of treatment
change from baseline in work productivity and activity impairment [assessed by the Work Productivity and Activity Impairment:Respiratory Symptoms (WPAI:RS) questionnaire]	Change from baseline in work productivity and activity impairment [assessed by the Work Productivity and Activity Impairment:Respiratory Symptoms (WPAI:RS) questionnaire]	after 16 and 48 weeks of treatment
clinician-assessed overall response to treatment using the Clinician Global Impression of Change (CGIC)	Clinician-assessed overall response to treatment using the Clinician Global Impression of Change (CGIC)	over the 48-week treatment period
patient-perceived overall response to treatment using the Patient Global Impression of Change (PGIC)	Patient-perceived overall response to treatment using the Patient Global Impression of Change (PGIC)	after 48 weeks of treatment
Percentage of patients remaining on treatment with benralizumab	Treatment persistence rate on therapy	at 48 weeks of treatment
Percentage of patients having discontinued treatment with benralizumab	Percentage of patients having discontinued treatment with benralizumab	at 48 weeks of treatment
description of reasons for treatment discontinuation	description of reasons for treatment discontinuation	at 48 weeks of treatment
time to treatment discontinuation	time to treatment discontinuation	at 48 weeks of treatment

Collaborators and Investigators

• Sponsor: AstraZeneca

Publications and helpful links

Helpful Links

• CSR Synopsis

Study record dates

Study Major Dates

• Study Start (Actual): June 29, 2022
• Primary Completion (Actual): April 13, 2025
• Study Completion (Actual): April 13, 2025

Study Registration Dates

• First Submitted: June 13, 2022
• First Submitted That Met QC Criteria: June 27, 2022
• First Posted (Actual): July 1, 2022

Study Record Updates

• Last Update Posted (Actual): April 15, 2026
• Last Update Submitted That Met QC Criteria: April 10, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Severe Asthma, Home Spirometry, Activity Tracker, Benralizumab
• Additional Relevant MeSH Terms: Immune System Diseases; Respiratory Tract Diseases; Lung Diseases; Bronchial Diseases; Lung Diseases, Obstructive; Respiratory Hypersensitivity; Hypersensitivity, Immediate; Hypersensitivity; Hypereosinophilic Syndrome; Eosinophilia; Leukocyte Disorders; Hematologic Diseases; Hemic and Lymphatic Diseases; Asthma; Pulmonary Eosinophilia; Health Care Quality, Access, and Evaluation; Investigative Techniques; Epidemiologic Methods; Health Care Evaluation Mechanisms; Quality of Health Care; Public Health; Environment and Public Health; Epidemiologic Studies; Epidemiologic Study Characteristics; Cohort Studies
• Other Study ID Numbers: D3250R00102

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

IPD Plan Description

Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal.

All request will be evaluated as per the AZ disclosure commitment:

https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure. Yes, indicates that AZ are accepting requests for IPD, but this does not mean all requests will be shared.

• IPD Sharing Time Frame: AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure
• IPD Sharing Access Criteria: When a request has been approved AstraZeneca will provide access to the deidentified individual patient-level data in an approved sponsored tool . Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure