New injectable treatment could be a game-changer for asthma and COPD patients

injections given during asthma; COPD Seizures are more effective than current treatment with steroid tablets, reducing the need for further treatment by 30%.

The findings of this study were announced today. lancet respiratory medicinescientists say, could be a “game changer” for millions of asthma and COPD patients around the world.

Asthma attacks and COPD flare-ups (also called exacerbations) can be fatal. Four people with asthma and 85 people with COPD tragically die every day in the UK. Both conditions are extremely common, with someone having an asthma attack every 10 seconds in the UK. Asthma and COPD cost the NHS £5.9 billion a year.

The type of flare-up treated with this injection is called an “eosinophilic exacerbation,” and is accompanied by symptoms such as wheezing, coughing, and chest tightness due to difficulty breathing. inflammation It is caused by large amounts of eosinophils (a type of white blood cell). Eosinophilic exacerbations account for up to 30% of COPD flare-ups and almost 50% of asthma attacks. They occur more frequently as the disease progresses and can, in some cases, lead to irreversible lung damage.

The treatment of this type of asthma exacerbation has remained largely unchanged for over 50 years, with steroids being the mainstay of drug therapy. Steroids such as prednisolone reduce inflammation in the lungs, but have serious side effects such as diabetes and osteoporosis. Furthermore, many patients “fail” treatment, requiring repeated doses of steroids, readmission to the hospital, or dying within 90 days.

Results from the ABRA study, a phase 2 clinical trial led by scientists at King's College London and sponsored by the University of Oxford, suggest that already available drugs can be repurposed in emergency situations to avoid the need for further treatment or hospitalization. It was shown that it is possible to reduce The multicentre trial was conducted at Oxford University Hospitals NHS Foundation Trust and Guy's and St Thomas' NHS Foundation Trust.

Benralizamab is a monoclonal antibody that targets specific white blood cells called eosinophils, reducing inflammation in the lungs. It is currently used to treat severe asthma. The ABRA trial found that a single dose given at the time of exacerbation was more effective compared to steroid tablets.

In this study, people at high risk of asthma or COPD attacks were randomly divided into three groups, with one group receiving benralizumab injections and dummy tablets, and one group receiving standard treatment (prednisolone 30 mg daily for 5 days) and dummy injections. and a third group received both benralizumab injections. and standard treatment. Because it was a double-blind, double-dummy, active comparator, placebo-controlled study, neither the study participants nor the principal investigator knew which study arm or treatment they received.

After 28 days, benralizumab was found to improve respiratory symptoms such as cough, wheezing, shortness of breath, and sputum production. After 90 days, the number of people failing treatment was reduced by a quarter in the benralizumab group compared with standard treatment with prednisolone.

Treatment with benralizumab injections took longer to fail, reducing the number of doctor visits and hospital visits. The quality of life of asthma and COPD patients has also improved.

This can be a game-changer for asthma and COPD patients. The treatment of asthma and COPD exacerbations has remained unchanged for 50 years, despite the fact that they collectively cause 3.8 million deaths per year worldwide.

Benralizumab is a safe and effective drug already used to manage severe asthma. We used this drug in a different way, at the point of exacerbation, to show that it is more effective than steroid tablets, the only treatment currently available. A major advance in ABRA research is the discovery that targeted therapies can help treat asthma and COPD attacks. Targeting patients at highest risk with very targeted treatments with appropriate levels of inflammation, rather than giving everyone the same treatment, is much better than guessing what treatment a patient needs. I found out that there is. ”

Mona Buffadel, lead investigator on the case and professor at King's College London

In this study, the benralizumab injection was administered by a health care professional, but it could also be safely administered at home, in your GP's office, or in the emergency department. Benralizumab was safe in the study and in line with many previous studies in terms of safety.

Professor Mona Buffadel said: “These pivotal studies will change the way asthma and COPD exacerbations are treated in the future, ultimately improving the health of the more than one billion people living with asthma and COPD around the world. I look forward to doing so.”

Dr Sanjay Ramakrishnan, lead author of the ABRA trial and senior clinical lecturer at the University of Western Australia, who initiated the research while at Oxford, said: “Our study shows great promise for the treatment of asthma and COPD. COPD is the third leading cause of death worldwide, but treatment for this disease is stuck in the 20th century. We need to provide these patients with life-saving options before time runs out.

“The ABRA trial is only possible through collaboration between the NHS and universities and shows how this close relationship can innovate healthcare and improve people's lives.”

Geoffrey Pointing, 77, from Banbury, who took part in the study, said: 'Honestly, when your symptoms are getting worse, it's very difficult to tell someone how you're feeling. You can't even breathe. . Anything that takes away that.” Returning to normal life is what you want. However, with the injection, there were no side effects, such as not being able to sleep well the first night I took it. Although I had to take steroids, I was able to sleep through the first night of the study and was able to continue my daily life without any problems. I would like to add that I am grateful for my participation and everyone involved in the study. ABRA's research is going to give me a better life. ”

Dr Samantha Walker, director of research and innovation at Asthma + Lung UK, said: 'A potential alternative to steroid tablets has been discovered to treat asthma attacks and chronic obstructive pulmonary disease (COPD). “This is good news for people with lung disease.” But the fact that this is the first new treatment for people suffering from asthma and COPD attacks in 50 years is frightening and shows how desperately underfunded research into lung health is.

“Every four minutes someone dies from a lung disease in the UK. Thousands more live in fear of having trouble breathing every day. With your help, we can change the future. We are fighting for more life-changing, life-saving research for people living with breathing problems.Together, we can help families around the world get the best treatment and treatment for everyone living with breathing problems. We will ensure that you do not face lung disease without care.

“Our vision is a world where everyone has healthy lungs, and we can't get there without your help.”

This study was supported by AstraZeneca UK Limited.

The paper was published in The Lancet Respiratory Medicine, titled “Phase II clinical trial suggests monoclonal antibody is better than standard treatment for some types of asthma attacks and COPD flare-ups.”