{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T14:41:53Z","timestamp":1776091313944,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.24603.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T00:00:00Z","timestamp":1595462400000}}],"reference-count":18,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T00:00:00Z","timestamp":1595462400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"\n Background<\/ns4:bold>\n : Monoclonal antibodies are a relatively new therapeutic option for patients with severe refractory asthma, which can be used as an add-on to maintenance therapy, reducing the need for systemic corticosteroid usage, improving asthma symptom control and reducing exacerbations. We report a case of a patient with severe refractory eosinophilic asthma, reluctant to take systemic steroids, who was successfully treated with benralizumab alone during an acute asthma attack.\n <\/ns4:p>\n \n Case presentation<\/ns4:bold>\n : A 59-year-old Caucasian woman with a history of allergic asthma since childhood showed a progressive decline in lung function with difficult to control symptoms and an increased number of hospitalizations despite maximal maintenance treatment, and was diagnosed with severe refractory asthma. She was reluctant to take systemic corticosteroids during exacerbations due to severe urinary retention; therefore, she started omalizumab with a partial reduction of symptoms and exacerbations over time. During a follow-up visit, she showed signs of acute exacerbation and she was switched to benralizumab during her acute phase with a rapid, dramatic amelioration of respiratory symptoms and pulmonary function, without concomitant systemic corticosteroid administration. During the treatment and at follow-up after one month, good tolerance and no side effects were observed.\n <\/ns4:p>\n \n Conclusions<\/ns4:bold>\n : The use of benralizumab seems to be feasible, rapid, and safe in treating acute exacerbation of severe eosinophilic asthma without the use of systemic corticosteroids.\n <\/ns4:p>","DOI":"10.12688\/f1000research.24603.2","type":"journal-article","created":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T08:55:06Z","timestamp":1595494506000},"page":"637","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Case Report: Acute effect of benralizumab on asthma exacerbation without concomitant corticosteroid use"],"prefix":"10.12688","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3995-7662","authenticated-orcid":false,"given":"Santi","family":"Nolasco","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaele","family":"Campisi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rossella","family":"Intravaia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morena","family":"Porto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4236-7367","authenticated-orcid":false,"given":"Corrado","family":"Pelaia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nunzio","family":"Crimi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9088-5214","authenticated-orcid":false,"given":"Claudia","family":"Crimi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2020,7,23]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/1471-2466-9-24","article-title":"Economic burden of asthma: a systematic review.","volume":"9","author":"K Bahadori","year":"2009","journal-title":"BMC Pulm Med."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"61-67","DOI":"10.1183\/09031936.02.00232001","article-title":"Costs of asthma are correlated with severity: a 1-yr prospective study.","volume":"19","author":"P Godard","year":"2002","journal-title":"Eur Respir J."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"113-120","DOI":"10.1080\/17425255.2019.1568409","article-title":"Pharmacokinetics and pharmacodynamics of monoclonal antibodies for asthma treatment.","volume":"15","author":"D Bagnasco","year":"2019","journal-title":"Expert Opin Drug Metab Toxicol."},{"key":"ref-4","article-title":"Global strategy for Asthma Management and Prevention","year":"2016"},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"343-373","DOI":"10.1183\/09031936.00202013","article-title":"International ERS\/ATS guidelines on definition, evaluation and treatment of severe asthma.","volume":"43","author":"K Chung","year":"2014","journal-title":"Eur Respir J."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"375-382","DOI":"10.1097\/ACI.0000000000000284","article-title":"Biologic therapy in the management of asthma.","volume":"16","author":"J McCracken","year":"2016","journal-title":"Curr Opin Allergy Clin Immunol."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"823-829","DOI":"10.1164\/rccm.201809-1817PP","article-title":"Unmet Needs in Severe Asthma Subtyping and Precision Medicine Trials. 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Med."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/9-637\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/9-637\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/9-637\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T04:10:40Z","timestamp":1597896640000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/9-637\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,23]]},"references-count":18,"URL":"https:\/\/doi.org\/10.12688\/f1000research.24603.2","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.28193.r67879","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.28193.r67879","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,23]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/9-637\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.28193.r67879, Paula Kauppi, Inflammation Centre, Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland, 20 Aug 2020, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/9-637\/v2#referee-response-67879","order":0,"name":"referee-response-67879","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.27141.r65420, Claudio Micheletto, Cardio-Thoracic Dept, Respiratory Unit, Integrated University Hospital, Verona, Italy, 08 Jul 2020, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/9-637\/v1#referee-response-65420","order":1,"name":"referee-response-65420","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"Claudia Crimi<\/b>; \nPosted: 17 Jul 2020<\/i>; Dear Dr. Micheletto, Thank you for your time and consideration in reviewing our article. We are glad that you find our case report interesting.  We were thrilled to read the approval from an expert in the field like you. We have now added a bit more information as you requested.    Best Regards,   Claudia Crimi, MD, PhD  ___________________________ \nSpecific point-by-point response:<\/b> The Authors presented a case report on the use of benralizumab administration during an acute attack of severe refractory eosinophilic asthma, without the concomitant use of systemic steroids. Benralizumab is an anti-receptor monoclonal anti-IL-5 antibody, which has been shown to be particularly effective in reducing exacerbations, used as regular therapy in severe eosinophilic asthma. ·        How was the patient's adherence to inhalation therapy? \nReply:<\/b>Thank you for your comment. Based on your suggestion we have added a sentence stating that patient's adherence to both inhaled (ICS + LABA and LAMA) and oral (theophylline and Montelukast) therapy, continue to be very good, also due to her fear of possible need for intravenous\/oral steroids in case of non-adequate adherence. ·        Did the patient have a previous accurate diagnosis of severe asthma? \nReply:<\/b>Thank you for your comment. We diagnosed severe asthma according to ERS\/ATS guidelines [1]; therefore, we excluded other respiratory diseases that may share common clinical manifestations of severe asthma (i.e., bronchopulmonary aspergillosis, vasculitis, chronic cough). We have now specified it in the text and added the appropriate reference as below.   Chung KF, Wenzel SE, Brozek JL, et al.: International ERS\/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J. 2014; 43(2): 343\u2013373.   ·        Was the patient then regularly treated with benralizumab? \nReply: <\/b>Thank you for pointing out this aspect. Yes, the patient was then treated regularly with benralizumab 30 mg subcutaneously every four weeks for the first three doses and then every eight weeks. We have better clarified this in the text (paragraph follow-up and outcomes, last sentence). ·        Were eosinophils measured in the following weeks? \nReply:<\/b>Thank you for highlighting this aspect. Yes, we executed blood eosinophils count 48h and exactly four weeks after the first benralizumab administration (right before the second dose), showing a complete eosinophils depletion in both determinations (as described in the paragraph follow-up and outcomes). Moreover, a blood test was performed before every next benralizumab dose. We have now better specify this aspect in the text (paragraph follow-up and outcomes, last sentence).","URL":"https:\/\/f1000research.com\/articles\/9-637\/v2#referee-comment-5740","order":2,"name":"referee-comment-5740","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}