Adrenal function recovery after durable oral corticosteroid sparing with benralizumab in the PONENTE study

Background Oral corticosteroid (OCS) dependence among patients with severe eosinophilic asthma can cause adverse outcomes, including adrenal insufficiency. PONENTE's OCS reduction phase showed that, following benralizumab initiation, 91.5% of patients eliminated corticosteroids or achieved a final dosage ≤5 mg·day-1 (median (range) 0.0 (0.0-40.0) mg). Methods The maintenance phase assessed the durability of corticosteroid reduction and further adrenal function recovery. For ~6 months, patients continued benralizumab 30 mg every 8 weeks without corticosteroids or with the final dosage achieved during the reduction phase. Investigators could prescribe corticosteroids for asthma exacerbations or increase daily dosages for asthma control deteriorations. Outcomes included changes in daily OCS dosage, Asthma Control Questionnaire (ACQ)-6 and St George's Respiratory Questionnaire (SGRQ), as well as adrenal status, asthma exacerbations and adverse events. Results 598 patients entered PONENTE; 563 (94.1%) completed the reduction phase and entered the maintenance phase. From the end of reduction to the end of maintenance, the median (range) OCS dosage was unchanged (0.0 (0.0-40.0) mg), 3.2% (n=18/563) of patients experienced daily dosage increases, the mean ACQ-6 score decreased from 1.26 to 1.18 and 84.5% (n=476/563) of patients were exacerbation free. The mean SGRQ improvement (-19.65 points) from baseline to the end of maintenance indicated substantial quality-of-life improvements. Of patients entering the maintenance phase with adrenal insufficiency, 32.4% (n=104/321) demonstrated an improvement in adrenal function. Adverse events were consistent with previous reports. Conclusions Most patients successfully maintained maximal OCS reduction while achieving improved asthma control with few exacerbations and maintaining or recovering adrenal function

Post-capitalistic politics in the making: The imaginary and praxis of alternative economies

In June 2015, we launched the call for articles for this special issue in an attempt to catalyze the rising awareness, both within the critically oriented and the broader organization studies community, that we are today witnessing epochal changes, which are fundamentally redefining the social, economic, political, and environmental realities we live in in unforeseen and unimaginable ways. For many of us, the financial crisis of 2008 had crystallized the notion that capitalism in its very nature is in continuous crisis, as shown by four decades of persistent decline in economic growth rate and rise in overall indebtedness and economic inequality (Streeck, 2014, 2016). Yet the political debacle of party politics in the United Kingdom and the United States together with the rampant populism in various European countries have highlighted that this is not just another installment of a crisis-prone economic system. These ‘electoral mutinies’ suggest that what is under crisis is the governance system of neoliberalism itself (Fraser, 2017). The responses to this crisis have been proved severely wanting, leading to the weakening of all social and political institutions that offer a semblance of protection to the vulnerable (Wahl, 2017)