Benralizumab reduces sputum ANCA in patients with eosinophilic granulomatosis with polyangiitis
Bibliographic record
Abstract
<title>Extract</title> Eosinophilic Granulomatosis with Polyangiitis (EGPA) is a rare vasculitis characterized by eosinophilic inflammation and autoimmune features, with anti-neutrophil cytoplasmic antibodies (ANCA) against myeloperoxidase (MPO) (pANCA) detectable in serum in up to 40% of patients. Seronegative EGPA can be associated with severe cardiac and pulmonary complications, including uncontrolled asthma [1]. We previously observed ANCA in sputum (spANCA) in 74% of EGPA patients, regardless of serum pANCA status, all of whom had severe asthma requiring high-dose oral corticosteroids [2]. These findings suggest that a localized airway autoimmune response may drive disease severity. Mepolizumab and benralizumab—monoclonal antibodies targeting IL-5 and IL-5Rα, respectively—are approved therapies that induce remission and reduce corticosteroid use in EGPA. Benralizumab has demonstrated non-inferiority to mepolizumab in relapsing or refractory cases [3]. Our primary objective was to investigate whether benralizumab and mepolizumab exert differential effects on airway autoimmune responses in EGPA. Airway autoimmunity is increasingly recognized as a key determinant of pulmonary outcomes in EGPA, and its modulation may influence treatment efficacy [2, 4]. To address this, we analyzed sputum, nasal lavage, and blood samples from sixteen patients enrolled in the randomized, double-blind MANDARA trial (<ext-link>NCT04157348</ext-link>).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".