Scientists have found a new treatment for people with asthma and chronic obstructive pulmonary disease (COPD) that may be more effective than current options.
Over the past 50 years, treatment options in the event of an asthma or COPD attack—a similar event—have been relatively unchanged.
"The only treatment we have for attacks are steroids, which aren't always effective and can have serious side effects," Professor Mona Bafadhel, lead investigator of a trial of a new treatment from King's College London, told Newsweek.
When patients are given steroids, such as a medication called prednisolone, to treat an asthma attack, it may reduce lung inflammation but increase the risk of serious conditions such as diabetes or osteoporosis.
Many patients on steroids fail treatment, which means they may need more steroids, have to be re-hospitalized or die within 90 days.
Bafadhel's team studied the effect of injecting patients with benralizumab, a lab-made protein designed to act like an antibody, targeting specific white blood cells called eosinophils to reduce lung inflammation.
Eosinophils are responsible for approximately 30 percent of COPD flare-ups and half of asthma attacks.
Benralizumab is currently used to treat severe asthma but is not used to treat COPD or asthma attacks.
Bafadhel's team randomly assigned more than 150 asthma and COPD patients being treated in emergency departments of English hospitals into three groups: one received benralizumab and dummy tablets, one received steroids and a dummy injection, and one received both benralizumab and steroids.
The ABRA study was a double-blind, double-dummy, placebo-controlled trial, so neither the patients nor the researchers knew who got what.
After 28 days, respiratory symptoms—coughing, wheezing, breathlessness and sputum—were better with benralizumab.
After 90 days, there were four times fewer people in the benralizumab group who failed treatment, compared to the group receiving steroid drugs. People who were given benralizumab also reported an improved quality of life.
Asthma is a chronic lung condition that inflames and narrows the airways in the lungs. It affects 6.2 percent of children and 8.7 percent of adults in the U.S., according to data from the Centers for Disease Control and Prevention (CDC) collected in 2022.
It can make breathing difficult and trigger symptoms such as wheezing, coughing and shortness of breath.
"It's a common condition, but for many, it's a major condition that interferes with daily activities such as work, exercise and caregiving," said Bafadhel.
"An asthma attack can be serious and life-threatening when you experience rapid worsening or shortness of breath, and you see no improvement in your symptoms after using an inhaler."
COPD is a long-term lung condition in which the airways become damaged or blocked, often because of smoking or air pollution. Nearly 16 million U.S. adults have COPD, according to the CDC.
Geoffrey Pointing, 77, who took part in the study, said in a statement: "Honestly, when you're having a flare up, it's very difficult to tell anybody how you feel—you can hardly breathe.
"Anything that takes that away and gives you back a normal life is what you want. But on the injections, it's fantastic. I didn't get any side effects like I used to with the steroid tablets."
Pointing said that steroid treatments used to interfere with his sleep, but he could sleep well on benralizumab.
"I'm just grateful I took part and that everyone involved in the ABRA study are trying to give me a better life," he said.
Bafadhel said in a statement that this treatment "could be a game-changer for people with asthma and COPD" and that benralizumab was "safe and effective."
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Reference
Ramakrishnan, S., Russell, R. E. K., Mahmood, H. R., Krassowska, K., Melhorn, J., Mwasuku, C., Pavord, I. D., Bermejo-Sanchez, L., Howell, I., Mahdi, M., Peterson, S., Bengtsson, T., Bafadhel, M. (2024). Treating eosinophilic exacerbations of asthma and COPD with benralizumab (ABRA): a double-blind, double-dummy, active placebo-controlled randomised trial, The Lancet Respiratory Medicine. https://doi.org/10.1016/S2213-2600(24)00299-6