Patients' perspectives of eosinophilic granulomatosis with polyangiitis within the context of a clinical trial.

Objectives: Eosinophilic granulomatosis with polyangiitis (EGPA) is a complex, multisystem form of vasculitis. MANDARA (NCT04157348) was a phase 3 clinical trial comparing the efficacy and safety of benralizumab versus mepolizumab, in addition to standard of care, for relapsing/refractory EGPA. This qualitative interview substudy explored study participants' experiences with EGPA and their participation in the trial. Methods: Thirty-eight patients from 5 countries participating in MANDARA opted into a longitudinal qualitative substudy, which comprised two 60-minute, semistructured, one-to-one telephone interviews conducted by trained interviewers between December 2019 and June 2023. Topics discussed included motivation to join the trial, time since diagnosis, symptoms, and impacts of EGPA and their degree of 'bothersomeness' and 'disturbance'. Results: The desire to stop or reduce the use of oral glucocorticoids was the most frequently mentioned motivation for, and expectation of, participation in the trial. Comparison of interviews between the 2 time points suggested patients experienced reductions in the number and impact of EGPA-related symptoms and bothersomeness and/or disturbance ratings. Most improved symptoms included difficulty breathing, nasal congestion/discharge, and fatigue, and most improved impacts included ability to exercise, quality/quantity of sleep, and ability to engage in social activities. Conclusions: This study provides insights regarding patients' perspectives of EGPA and their perceptions and experiences associated with receiving an anti-interleukin-5/receptor therapy. These findings highlight the need for effective treatments that allow patients to reduce their use of oral glucocorticoids and the importance of assessing patient experiences when gauging treatment efficacy in EGPA.