A new method for addressing serious asthma and chronic obstructive pulmonary disease (COPD) attacks may be a “game-changer” and represents the first significant advancement in treatment in 50 years, according to researchers.
Providing patients with an injection has proven to be more effective than the current approach involving steroid tablets, reducing the need for additional treatment by 30%, as indicated by a study.
The research involved 158 patients who were monitored over a three-month period following an exacerbation.
The drug, Benralizumab, is not yet ready for general use, and experts emphasize that a much larger trial is necessary to confirm any benefits.
Benralizumab is a monoclonal antibody designed to target specific white blood cells, known as eosinophils, to reduce lung inflammation.
Currently, it is utilized as a repeated treatment for severe asthma at a low dosage; however, a new clinical trial has demonstrated that administering a higher single dose at the time of an exacerbation can be highly effective.
The findings, published in the Lancet Respiratory Medicine, examined 158 individuals who required hospital treatment for their asthma or COPD attack (COPD encompasses a range of lung conditions that result in breathing difficulties).
Patients underwent a quick blood test to determine the nature of their attack, with those experiencing an “eosinophilic exacerbation” identified as suitable for treatment.
According to the researchers, approximately 50% of asthma attacks and 30% of COPD attacks are eosinophilic exacerbations.
The clinical trial, led by King’s College London and conducted at Oxford University Hospitals NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust, assigned patients randomly to three groups.
One group received the Benralizumab injection along with placebo tablets, the second group received standard care (prednisolone steroids at 30mg daily for five days) and a placebo injection, while the third group received both the Benralizumab injection and steroids.
After 28 days, patients in the Benralizumab group reported improved respiratory symptoms such as cough, wheeze, breathlessness, and sputum production.
Additionally, after 90 days, there were four times fewer individuals in the Benralizumab group who experienced treatment failure compared to those receiving steroids.
The treatment with the Benralizumab injection also demonstrated a longer duration before failure, leading to fewer visits to a GP or hospital for patients, researchers noted.
Moreover, participants reported an improved quality of life under the new treatment regimen.
The trial was spearheaded by King’s College London.
Scientists at King’s highlighted that steroids can pose severe side effects, including an increased risk of diabetes and osteoporosis, suggesting that a switch to Benralizumab could yield significant advantages.
Lead investigator Professor Mona Bafadhel from King’s stated: “This could be a game-changer for individuals with asthma and COPD.”
“Treatment options for asthma and COPD exacerbations have remained unchanged for 50 years, despite causing 3.8 million deaths globally each year.”
“Benralizumab is a safe and effective medication already used to manage severe asthma.”
“We have utilized the drug in a novel way—at the time of exacerbation—to demonstrate that it is more effective than the current sole treatment available: steroid tablets.”
Researchers suggested that Benralizumab could potentially be administered safely at home or in a GP practice, in addition to hospitals.
First author Dr. Sanjay Ramakrishnan, a clinical senior lecturer at the University of Western Australia, remarked that the study “shows tremendous promise” for the treatment of asthma and COPD.
“COPD remains the third leading cause of death worldwide, yet its treatment has not progressed since the 20th century,” he emphasized.
“We must provide these patients with life-saving alternatives before it’s too late.”
Dr. Samantha Walker, director of research and innovation at Asthma and Lung UK, welcomed the findings but expressed concern: “It’s disheartening that this is the first new treatment available for those suffering from asthma and COPD attacks in 50 years, highlighting the urgent need for increased lung health research funding.”
AstraZeneca supplied the drug used in the study and funded the research, but they were not involved in the trial’s design, execution, analysis, or interpretation.
Many individuals with asthma rely on inhalers.
The Medical Director at the Asthma Society of Ireland noted that the new drug provides genuine hope for sufferers seeking to reduce the harm and side effects associated with conventional steroid treatments.
“The side effects can be quite pronounced,” Professor Marcus Butler stated.
“Long-term use of steroids often leads to noticeable weight gain, which is a visible side effect.”
“Patients may notice thinning skin, paper-like texture, and they are at risk of osteoporosis and life-altering fractures later in life. Vision loss from cataracts and the potential onset of diabetes are also concerns.”
“It’s a long list of side effects, many of which are largely absent with these alternative injections.”
Speaking on RTÉ’s Today with Claire Byrne, Professor Butler noted that while the new treatment is still in phase two trials and requires validation on a larger scale, it targets eosinophil inflammation and will be primarily beneficial for patients experiencing these specific flare-ups.
Both patient populations for these diseases frequently occupy emergency departments globally during flare-ups, he added.
He estimated the treatment could cost “many thousands of euro annually” for a patient.
However, this study proposes administering a higher dosage at the onset of illness to potentially mitigate flare-ups over the following three months.
