Targeting IL-5, a survival factor for eosinophils, has emerged as an effective and steroid-sparing strategy for the treatment of eosinophilic granulomatosis with polyangiitis (EGPA), with the anti-IL-5 agent mepolizumab becoming the first targeted therapy to be approved for use in EGPA. Now, the results of the phase III MANDARA trial demonstrate that benralizumab, a monoclonal antibody that targets the IL-5α receptor expressed on eosinophils, is noninferior to mepolizumab for the induction of remission in patients with EGPA receiving standard care.

Both mepolizumab and benralizumab are already used for the treatment of severe eosinophilic asthma. The findings of the MANDARA trial build on observational data suggesting that benralizumab is effective and safe as an add-on treatment for patients with EGPA.