#2-04E. The New Frontier in EGPA: Benralizumab vs. Mepolizumab for Glucocorticoid Discontinuation (Arthritis Rheumatol, 2024)

Reducing oral glucocorticoids (OGCs) is a primary goal in managing eosinophilic granulomatosis with polyangiitis (EGPA) to mitigate long-term toxicity. This episode delves into a post-hoc analysis of the MANDARA trial, which compared the OGC-sparing effects of benralizumab and mepolizumab in EGPA patients. While both biologics effectively reduced OGC use, the study's key finding is that a significantly higher proportion of patients treated with benralizumab achieved and sustained complete OGC withdrawal compared to those on mepolizumab. However, it is crucial to note that this was a post-hoc analysis, and the OGC tapering protocol was not standardized, relying on investigators' clinical judgment. For clinicians, these findings reinforce the efficacy of eosinophil-targeting therapies and suggest that complete OGC withdrawal is an achievable new treatment goal, potentially shifting therapeutic strategies for EGPA management.

Citation: Nair, Parameswaran K., et al. The Effect of Benralizumab and Mepolizumab on Use of Oral Glucocorticoids in Patients with Eosinophilic Granulomatosis with Polyangiitis. Arthritis & Rheumatology. 2024. DOI: 10.1002/art.43398.

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