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Independent commentary for the review has been provided by Associate Professor Claude Farah, an adult respiratory and sleep physician at Concord Hospital and Macquarie University Hospital, Sydney.

In the SHAMAL study, adults with severe eosinophilic asthma controlled on benralizumab were randomised to either taper their high-dose inhaled corticosteroids (ICS) or continue their current therapy for 32 weeks, followed by a 16-week maintenance period. Most patients in the reduction group successfully reduced their ICS-formoterol dose, with reductions maintained through Week 48. Reductions included transitioning to medium-dose, low-dose, or as-needed-only ICS. Additionally, patients in the reduction group experienced no exacerbations during tapering, and adverse event (AE) rates were similar between groups. These results suggest that patients controlled on benralizumab can safely reduce ICS therapy while maintaining asthma control.

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