Out of Breath, out of Options: Benralizumab as a Last Hope in ICU-Treated Near-Fatal Eosinophilic Asthma

Asthma exacerbations remain life-threatening events despite advancements in biologic therapies. This case series reports on four patients with near-fatal 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-threatening asthma exacerbations driven by eosinophilic airway inflammation and underlines the need for phenotyping and timely intervention in managing such patients with near-fatal asthma while also stressing the need for continued adherence to asthma guidelines to prevent these extreme situations.