First breakthrough for asthma and COPD treatment for 50 years treats flares without nasty steroid side effects

11/27/2024 06:30 PM

THE first new treatment for asthma attacks in 50 years has been developed and could be “game-changing” for millions of people with the condition.

Asthma attacks and chronic obstructive pulmonary disease (COPD) flare-ups – also known as exacerbations – can be deadly.

Four people with asthma and 85 people with COPD die every day in the UK, according to official figures – with someone having an asthma attack every 10 seconds.

People with the conditions are currently treated with steroid tablets.

But now an injection has been shown to be more effective, reducing the need for further treatment by 30 per cent.

Researchers say their findings, published in The Lancet Respiratory Medicine, could be “game-changing” for millions of people with asthma and COPD around the world.

Lead investigator of the trial Professor Mona Bafadhel from King's College London said: "This could be a game-changer for people with asthma and COPD.

“Treatment for asthma and COPD exacerbations have not changed in fifty years despite causing 3.8 million deaths worldwide a year combined.”

The injection treat flare-ups called “eosinophilic exacerbation” and involve symptoms including wheezing, coughing and chest tightness due to inflammation resulting from high amounts of eosinophils, a type of white blood cell.

Eosinophilic exacerbations make up to 30 per cent of COPD flare-ups and almost half of asthma attacks.

Until now, steroid drugs have been the main medication.

Steroids like prednisolone can reduce inflammation in the lungs but have severe side effects such as diabetes and osteoporosis.

Many patients also “fail” treatment and need repeated courses of steroids, re-hospitalisation or die within 90 days.

The study, led by scientists at King’s College London and sponsored by the University of Oxford, looked at benralizamab, a drug already available that could be re-purposed in emergency settings.

The research team explained benralizamab is a monoclonal antibody which targets eosinophils to reduce lung inflammation

It’s currently used for the treatment of severe asthma.

The trial found a single dose can be more effective when injected at the point of exacerbation compared to steroid tablets.

Participants in the study, who were high risk of an asthma or COPD attack, were split into three groups by the research team.

One group received benralizamab 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. 

Neither the people in the study, or the study investigators knew which study arm or treatment they were given.

After 28 days, respiratory symptoms of cough, wheeze, breathlessness and sputum were found to be better 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 took longer to fail, meaning fewer episodes to see a doctor or go to hospital.

There was also an improvement in the quality of life for people with asthma and COPD.

Prof Bafadhel said: "Benralizumab is a safe and effective drug already used to manage severe asthma.

“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.

"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."

Dr Sanjay Ramakrishnan, Clinical Senior Lecturer at the University of Western Australia, who is the first author of the ABRA trial and started the work while at the University of Oxford, said: "Our 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.

Dr Samantha Walker, Director of Research and Innovation, at Asthma + Lung UK, added: "It's great news for people with lung conditions that a potential alternative to giving steroid tablets has been found to treat asthma attacks and chronic obstructive pulmonary disease (COPD) exacerbations.

“But it's appalling that this is the first new treatment for those suffering from asthma and COPD attacks in 50 years, indicating how desperately underfunded lung health research is. 

"Every four minutes in the UK, someone dies from a lung condition. Thousands more live with the terror of struggling to breathe every day. With your help, we’re fighting for more life-changing, life-saving research to transform the future for everyone living with breathing problems. Together, we'll make sure that families everywhere never face a lung condition without the best treatment and care.  

"Our vision is a world where everyone has healthy lungs. We can only get there with your help."