A new way of treating serious asthma and chronic obstructive pulmonary disease (COPD) attacks could be a “game-changer” and lead to the first leap in treatment for 50 years, researchers have said.
A new study found offering patients an injection is more effective than the current care of steroid tablets and cuts the need for further treatment by 30%.
Benralizumab is a monoclonal antibody that targets specific white blood cells, called eosinophils, to reduce lung inflammation.
It is currently used as a repeat treatment for severe asthma at a low dose. However, a new clinical trial has found that a higher single dose can be very effective if injected at the time of a flare-up.
The findings, published in the Lancet Respiratory Medicine, included 158 people who needed medical attention in A&E for their asthma or COPD attack (COPD is a group of lung conditions that cause breathing difficulties).
Patients were given a quick blood test to see what type of attack they were having, with those suffering an “eosinophilic exacerbation” involving eosinophils (a type of white blood cell) being suitable for treatment.
Around 50% of asthma attacks are eosinophilic exacerbations, as are 30% of COPD ones, according to the scientists.
The clinical trial, led by King’s College London and carried out at Oxford University Hospitals NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust, saw patients randomly split into three groups.
One group received the benralizumab injection and dummy tablets, another received standard care (prednisolone steroids 30mg daily for five days) and a dummy injection, and the third group received both the benralizumab injection and steroids.
After 28 days, respiratory symptoms of cough, wheeze, breathlessness and sputum were found to be better in people on benralizumab.
And after 90 days, there were four times fewer people in the benralizumab group who failed treatment compared with those receiving steroids.
Treatment with the benralizumab injection also took longer to fail, meaning fewer visits to a GP or hospital for patients, researchers said.
Furthermore, people also reported a better quality of life on the new regime.
Scientists at King’s said steroids can have severe side-effects such as increasing the risk of diabetes and osteoporosis, meaning switching to benralizumab could provide huge benefits.
Lead investigator Professor Mona Bafadhel, from King’s, said: “This could be a game-changer for people with asthma and COPD.
“Treatment for asthma and COPD exacerbations have not changed in 50 years, despite causing 3.8 million deaths worldwide a year combined.
“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.”
Researchers said benralizumab could also potentially be administered safely at home or in a GP practice, as well as in A&E.