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This case series reports on four patients with near\u2010fatal eosinophilic asthma exacerbations who had been admitted to intensive care and were treated with benralizumab as a last resort after failing maximal standard therapies. All patients exhibited marked blood or airway eosinophilia and required intensive care ventilatory support. Following the administration of benralizumab, significant clinical improvements were observed. This series highlights the potential role of benralizumab in treating life\u2010threatening asthma exacerbations driven by eosinophilic airway inflammation and underlines the need for phenotyping and timely intervention in managing such patients with near\u2010fatal asthma while also stressing the need for continued adherence to asthma guidelines to prevent these extreme situations.<\/jats:p>","DOI":"10.1002\/rcr2.70117","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T00:05:51Z","timestamp":1741824351000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Out of Breath, out of Options: Benralizumab as a Last Hope in <scp>ICU<\/scp>\u2010Treated Near\u2010Fatal Eosinophilic Asthma: A Case Series"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2348-1826","authenticated-orcid":false,"given":"Lennart","family":"Conemans","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine Maastricht University Medical Centre  Maastricht the Netherlands"},{"name":"NUTRIM Institute of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences Maastricht University  Maastricht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emel","family":"Demir","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Ziekenhuis Maas en Kempen  Maaseik Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martijn","family":"Bischoff","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine Maastricht University Medical Centre+  Maastricht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1633-6356","authenticated-orcid":false,"given":"Frits","family":"Franssen","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Maastricht University Medical Centre  Maastricht the Netherlands"},{"name":"NUTRIM Institute of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences Maastricht University  Maastricht the Netherlands"},{"name":"Department of Research and Development Ciro  Horn the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4296-5076","authenticated-orcid":false,"given":"Sami","family":"Simons","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Maastricht University Medical Centre  Maastricht the Netherlands"},{"name":"NUTRIM Institute of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences Maastricht University  Maastricht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Global Initiative for Asthma \u201cGlobal Strategy for Asthma Management and Prevention \u201d2024."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2032506"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31322-8"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202003-0729LE"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-011-8274-y"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2022.02.029"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.24603.2"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202001-0093LE"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2014.09.036"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(24)00299-6"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.05.020"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201807-485AW"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202110-2265OC"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2022.03.003"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2023.02.009"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.13720"},{"key":"e_1_2_8_18_1","unstructured":"M. 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