Researchers have found that an injection given during some asthma and Chronic Obstructive Pulmonary Disease (COPD) attacks reduces the need for further treatment by 30 per cent, which is more effective than the current treatment of steroid tablets.
The researchers from King’s College London in a recent trial study published in The Lancet Respiratory Medicine showed that an already available drug, Benralizamab can be re-purposed in emergency settings to reduce the need for further treatment and hospitalisations during attacks.
Benralizamab is a monoclonal antibody currently used to treat severe asthma, targeting specific white blood cells, called eosinophils to reduce lung inflammation.
According to the researchers, while for over 50 years, steroid drugs have been the mainstay medication for asthma exacerbation; the trials have revealed that a single dose can be more effective when injected at the point of asthma exacerbation compared to steroid tablets.
They reported that the injection treats symptom flare-ups called ‘eosinophilic exacerbations’ and includes symptoms such as 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 50 per cent of asthma attacks and can become more frequent as the disease progresses, leading to irreversible lung damage in some cases.
The report explained that steroids such as prednisolone can reduce inflammation in the lungs; however, they have severe side effects such as diabetes and osteoporosis.
They also noted that many patients fail treatment and need repeated courses of steroids, re-hospitalisation or die within 90 days. For the study, the investigators randomised people at high risk of asthma or COPD attack into three groups, one receiving benralizumab injection and dummy tablets, one receiving standard of care including 30mg of prednisolone daily for five days along with a dummy injection and the third group receiving both benralizumab injections, as well as standard of care.
They found respiratory symptoms of cough, wheezing, breathlessness and sputum to be better with benralizumab after 28 days and after ninety days, there were four times fewer people in the benralizumab group that failed treatment compared to standard of care using prednisolone.
A professor and the lead investigator of the trial, Mona Bafadhel said that asthma causes about 3.8 million deaths worldwide, but the new result could be a game-changer for people with asthma and COPD.
Bafadhel said the breakthrough study has demonstrated that Benralizumab, a drug already in use for managing severe asthma, may offer superior treatment for exacerbations of asthma and COPD compared to traditional steroid tablets.
She highlighted that targeted treatment for patients with the highest risk and the appropriate inflammation levels yielded better outcomes than the conventional approach of uniform treatment.
According to Bafadhel, the injection, typically administered by healthcare professionals, could also be safely given in non-hospital settings such as at home, in general practice clinics, or in emergency departments. She added that safety data from the study reaffirmed that Benralizumab’s safety profile is consistent with previous research.
“We hope these pivotal studies will change how asthma and COPD exacerbations are treated in the future, ultimately improving the health of over a billion people living with asthma and COPD worldwide,” she said.
This discovery opens new avenues for patient-centred care in respiratory medicine, offering hope for improved outcomes and quality of life for millions affected by these chronic conditions.
