Patient-Reported Outcomes of Benralizumab in Real-World Use in Severe Eosinophilic Asthma Patients in Taiwan (BEAT)

Patient-Reported Outcomes of Benralizumab in Real-World Use in Severe Eosinophilic Asthma Patients in Taiwan

An open-label, single-arm, non-interventional, prospective, multicenter study involving primary data collection within real-world settings for patients who receive benralizumab for treatment of severe uncontrolled eosinophilic asthma

Study Overview

• Status: Completed
• Conditions: Asthma

Detailed Description

Benralizumab (Fasenra®) is a respiratory biologic agent targeting interleukin-5 (IL-5), an important member of the inflammatory cascade responsible for the pathogenesis of severe asthma. In 2019, Taiwan Food and Drug Administration (TFDA) approved benralizumab for the treatment of severe eosinophilic asthma (SEA). Since March 2020, benralizumab has been reimbursed by Taiwan National Health Insurance (NHI).

This prospective study (BEAT) aims to understand the use, effectiveness, and patient reported outcomes (PRO) of reimbursed benralizumab treatment in a real-world setting in Taiwan.

• Study Type: Observational
• Enrollment (Actual): 43

Contacts and Locations

Study Locations

• Taiwan
  • Changhua, Taiwan
    • Research Site
  • Kaohsiung City, Taiwan
    • Research Site
  • New Taipei City, Taiwan
    • Research Site
  • Tainan, Taiwan
    • Research Site
  • Taipei, Taiwan
    • Research Site
  • Taoyuan, Taiwan
    • Research Site

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study will recruit 57 adult patients with confirmed SEA who meet all inclusion criteria and none of the exclusion criteria. Approximately 8 hospitals will participate in the study which have experience with biologic treatment, can initiate treatment with benralizumab, and have a good oversight on the severe asthma population.

Description

Inclusion Criteria:

Subjects eligible for enrolment in the study and treated with benralizumab according to Taiwan label and reimbursement criteria must meet ALL the following criteria:

1. Male or female patients ≥ 18 years of age (or ≥ 20 years of age for patients enrolled before January 1st, 2023, according to age of majority as defined by Taiwan regulations), with physician's confirmed diagnosis of severe uncontrolled asthma
2. Asthma requiring medium- or high-dose inhaled corticosteroid plus long-acting β-adrenoceptor agonist as maintenance treatment

3. Patients who have been prescribed but not yet initiated* treatment with reimbursed benralizumab (Fasenra®) according to the 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. *Note: Treatment may be initiated (administration of first injection) at or after enrolment.

   Benralizumab Taiwan reimbursement criteria:

   • ≥ 2 acute exacerbations in the last 12 months, including at least 1 associated with emergency department (ED) visit or hospitalization; AND
   • At least 6 months of maintenance OCS use at ≥ 5 mg/day of prednisolone or equivalent dose; AND
   • Peripheral blood eosinophil ≥ 300 cells/μL in the last 12 months within the year before the initiation of benralizumab.
4. Provision of signed written informed consent form (ICF) indicating that they understand the purpose of the study and procedures required for participation
5. Patients must be able and willing to read, comprehend written instructions, and complete the paper questionnaires required by the protocol (ACQ-5, PGI-C, and PGI-S).

In case a patient does not own a smartphone or is not willing to perform the home spirometer, enrolment into the study is up to the physicians' discretion. We anticipate that 90% of patients will participate the home spirometer assessment.

Exclusion Criteria:

Subject must not meet ANY exclusion criteria:

1. Documented active lung diseases other than asthma and not within reimbursed label

2. Currently enrolled in an interventional clinical study in parallel, except:

   • Patients being in parallel documented in a national asthma registry
   • Patients having completed any other clinical trials including those with biologic treatment.
3. An acute or chronic condition that, in the investigator's opinion, would limit the patients' ability to complete questionnaires, participate in this study, or impact the interpretations of results.
4. Concurrent biologics for asthma are not allowed. Acceptable wash-out periods for other asthma biologics: ≥ 30 days from last dose of previous biologics.
5. Patients already started benralizumab treatment are not allowed. If the patients had received benralizumab treatment before, there should be an interval of ≥ 6 months from the last dose of prior benralizumab course to the newly initiated benralizumab treatment.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To evaluate the change in asthma control after initiation of benralizumab in a real-world Taiwan setting	Primary outcome measure: Changes from baseline in Asthma Control Questionnaire, five-question version (ACQ-5) scored from 0 (totally controlled) to 6 (severely uncontrolled)	after 8 weeks of benralizumab treatment
To evaluate the change in asthma control after initiation of benralizumab in a real-world Taiwan setting	Secondary outcome measure: Changes from baseline in ACQ-5 scored from 0 (totally controlled) to 6 (severely uncontrolled)	after 1, 2, 3, 4, 24, and 56 weeks of benralizumab treatment
To evaluate the change in asthma control after initiation of benralizumab in a real-world Taiwan setting	Secondary outcome measure: Percentage of patients with an improvement of ≥ 0.5 points (minimal clinically importance differences [MCID]) in ACQ-5 scored from 0 (totally controlled) to 6 (severely uncontrolled)	at 1, 2, 3, 4, 8, 24, and 56 weeks compared to baseline
To evaluate the change in asthma control after initiation of benralizumab in a real-world Taiwan setting	Percentage of patients with well-controlled asthma (ACQ-5 ≤ 0.75), partly controlled asthma (ACQ-5 between > 0.75 and < 1.5) and not well-controlled asthma (ACQ-5 ≥ 1.5) scored from 0 (totally controlled) to 6 (severely uncontrolled)	at 1, 2, 3, 4, 8, 24, and 56 weeks of benralizumab treatment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To assess change in overall asthma status and disease severity after initiation of benralizumab	Patient Global Impression of Change (PGI-C) response and PGI-C responder endpoint (a little better, moderately better, much better) The PGI-C is a single item designed to capture the participant's perception in change in overall disease status since the first dose of benralizumab using a 7-point scale (1- much better to 7- much worse)	at Week 1, 2, 3, 4, 8, 24, and 56 in asthma
To assess change in overall asthma status and disease severity after initiation of benralizumab	Patient Global Impression of Severity (PGI-S) in asthma The PGI-S is a single question designed to capture patient's perception of overall symptom severity on a scale of no symptom to very severe	Changes from baseline after 1, 2, 3, 4, 8, 24, and 56 weeks
To determine the change on lung function after treatment with benralizumab	Pre-bronchodilator changes in FEV1 and FVC assessed by standard hospital spirometry (if available)	after 24 and 56 weeks of treatment with benralizumab
To assess the rate and change of acute exacerbations after initiation of benralizumab in a real-world Taiwan setting	Annualized acute exacerbation rate and changes	from baseline at Week 24 and 56
To assess the rate and change of acute exacerbations after initiation of benralizumab in a real-world Taiwan setting	Proportion of patients with 0, 1, and ≥ 2 acute exacerbations	at Week 24 and 56
To assess the rate and change of acute exacerbations after initiation of benralizumab in a real-world Taiwan setting	Severity of exacerbation (use or temporary increase of systemic corticosteroids, emergency department visit, or hospitalization)	at Week 24 and 56
To assess the ability to reduce OCS dose after initiation of benralizumab in a real-world Taiwan setting	Mean and median OCS daily dose reductions	at Week 4, 8, 24, and 56
To assess the ability to reduce OCS dose after initiation of benralizumab in a real-world Taiwan setting	Proportion of patients with a ≥ 25%, ≥ 50%, ≥ 75%, and 100% OCS daily dose reduction	at Week 4, 8, 24, and 56
To assess the ability to reduce OCS dose after initiation of benralizumab in a real-world Taiwan setting	Changes from baseline in cumulated OCS dose	at Week 4, 8, 24, and 56
To describe characteristics of patients with benralizumab treatment in a real-world Taiwan setting	Baseline asthma disease history and commodities	known at the time of baseline data collection
To describe characteristics of patients with benralizumab treatment in a real-world Taiwan setting	Background medication	at baseline and at Week 4, 8, 24, and 56
To describe characteristics of patients with benralizumab treatment in a real-world Taiwan setting	Biomarker status (blood eosinophil and serum IgE level, if available)	at baseline and Week 4, 8, 24, and 56
To describe characteristics of patients with benralizumab treatment in a real-world Taiwan setting	Adherence to benralizumab scheduled dose during study period and investigator-chosen reasons for discontinuation	through study completion, up to 56 weeks
To describe characteristics of patients with benralizumab treatment in a real-world Taiwan setting	Most recent pre-bronchodilator FEV1 and FVC assessed by standard hospital spirometry	in the past 12 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
To determine the clinical utility of home spirometer in severe asthma patient management in a real-world Taiwan setting	Correlation of ACQ-5 and FEV1 changeand long term-outcome (ACQ-5, FEV1, annualized exacerbation rate, OCS reduction)	at Week 8, Week 24 and 56
To determine the clinical utility of home spirometer in severe asthma patient management in a real-world Taiwan setting	Correlation between home spirometer and standard spirometry	at baseline, Week 24 and 56
To determine the clinical utility of home spirometer in severe asthma patient management in a real-world Taiwan setting	Pre-bronchodilator changes in FEV1 assessed by home spirometer ("MIR" Spirobank Smart)	weekly from Week 1 to 4 and monthly from Week 8 to 56 during the treatment with benralizumab
To determine the clinical utility of home spirometer in severe asthma patient management in a real-world Taiwan setting	Pre-bronchodilator changes in FVC assessed by home spirometer ("MIR" Spirobank Smart)	weekly from Week 1 to 4 and monthly from Week 8 to 56 during the treatment with benralizumab
To determine the clinical utility of home spirometer in severe asthma patient management in a real-world Taiwan setting	Pre-bronchodilator changes in PEF assessed by home spirometer ("MIR" Spirobank Smart)	weekly from Week 1 to 4 and monthly from Week 8 to 56 during the treatment with benralizumab

Collaborators and Investigators

• Sponsor: AstraZeneca
• Investigators: Study Director: Clara Tsai, AstraZeneca

Publications and helpful links

Helpful Links

• CSR Synopsis

Study record dates

Study Major Dates

• Study Start (Actual): January 19, 2023
• Primary Completion (Actual): February 3, 2025
• Study Completion (Actual): February 3, 2025

Study Registration Dates

• First Submitted: December 15, 2022
• First Submitted That Met QC Criteria: February 16, 2023
• First Posted (Actual): February 17, 2023

Study Record Updates

• Last Update Posted (Actual): April 1, 2026
• Last Update Submitted That Met QC Criteria: March 27, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Immune System Diseases; Respiratory Tract Diseases; Lung Diseases; Bronchial Diseases; Lung Diseases, Obstructive; Respiratory Hypersensitivity; Hypersensitivity, Immediate; Hypersensitivity; Asthma
• Other Study ID Numbers: D3250R00109

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.