The first new treatment for asthma attacks in 50 years has been tested by British scientists.
The injection is more effective than the current method of steroid tablets—reducing the need for further treatment by 30%, according to a new study.
Researchers say their findings could be “game-changing” for millions of people around the world with asthma and chronic obstructive pulmonary disease (COPD)—especially because the drug is already available on the market.
Asthma attacks and COPD flare-ups, also known as “eosinophilic exacerbations”, can be deadly—with dozens of people dying every day in the UK after experiencing serious symptom flare-ups, according to official figures.
These exacerbations include symptoms like wheezing, coughing, and chest tightness due to inflammation resulting from high amounts of eosinophils, a type of white blood cell—and they involve almost half of asthma attacks and up to 30% of COPD flare-ups.
Yet medical treatments have barely changed for over half a century, as steroid drugs remained the mainstay of medication.
The downside of steroids like prednisolone, which can reduce inflammation in the lungs, is that they have severe side-effects, such as diabetes and osteoporosis. The treatment also fails many patients who need repeated courses of steroids, or get worse and need hospitalization within 90 days.
Results from the recent clinical trial led by scientists from King’s College London revealed that a drug already available can be re-purposed in emergency settings to reduce the need for further treatment.
“This could be a game-changer for people with asthma and COPD,” said lead investigator Professor Mona Bafadhel, of King’s College.
The team studied Benralizamab, a monoclonal antibody that targets eosinophils to reduce lung inflammation, which is currently used for the treatment of severe asthma—and the trial found a single dose can be four times more effective when injected at the point of exacerbation compared to steroid tablets.
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The study, which was published in The Lancet Respiratory Medicine, split people at high risk of an asthma or COPD attack into three groups. One group received benralizumab injection and dummy tablets, another received standard of care (prednisolone 30mg daily for five days) and dummy injection and the third group receiving both benralizumab injection and standard of care.
After 28 days, respiratory symptoms—like coughing, wheezing, and breathlessness—were reduced with benralizumab.
After 90 days, there were four times fewer people in the benralizumab group that failed treatment compared to standard of care with prednisolone.
Treatment with the benralizumab injection also led to fewer follow-up episodes that required seeing a doctor or going to a hospital. There was also an improvement in the quality of life for people with asthma and COPD.
“We’ve used the drug in a different way – at the point of an exacerbation – to show that it’s more effective than steroid tablets which is the only treatment currently available,” said Prof. Bafadhel.
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“The big advance is the finding that targeted therapy works in asthma and COPD attacks.”
The researchers say the jab can potentially be administered safely at home, too.
“We hope these pivotal studies will change how asthma and COPD exacerbations are treated for the future, ultimately improving the health for over a billion people living with asthma and COPD across the world,” she added.
Study first author Dr. Sanjay Ramakrishnan, who started the work while at Oxford University, said their study shows “massive promise” for asthma and COPD treatment.
“COPD is the third leading cause of death worldwide, but treatment for the condition is stuck in the 20th Century. We need to provide these patients with life-saving options before their time runs out.”
77-year-old patient Geoffrey Pointing, who took part of the study, called the injections “fantastic”.
“I didn’t get any side effects like I used to with the steroid tablets. I used to never sleep well the first night of taking steroids, but the first day on the study, I could sleep that first night, and I was able to carry on with my life without problems.”
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“Honestly, when you’re having a flare up, you can hardly breathe. Anything that takes that away and gives you back a normal life is what you want.
Dr Samantha Walker, director of research and Innovation, at Asthma + Lung UK, called the results “great news for people with lung conditions”.
“Every four minutes in the UK, someone dies from a lung condition but treatment for asthma and COPD exacerbations have not changed in 50 years despite causing 3.8 million deaths worldwide a year combined.”
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