A case of successful management with dupilumab in benralizumab-resistant asthma with allergic bronchopulmonary aspergillosis

Abstract

The patient was an 81-year-old woman with no smoking history. Since starting treatment with benralizumab for poorly controlled bronchial asthma with allergic bronchopulmonary aspergillosis (ABPA), her asthma was well controlled. However, two years after the initiation of benralizumab, her asthma and ABPA were exacerbated with increased peripheral blood eosinophil counts, which was speculated to be due to the decreased efficacy of benralizumab. After biologics were switched to dupilumab, both subjective symptoms and chest imaging improved. It was speculated that dupilumab may be effective for asthma with ABPA, even in benralizumab-resistant cases.