A drug already used in the treatment of severe asthma could help treat exacerbations in asthma and COPD, a UK trial has found.
Monoclonal antibody benralizamab was found to be more effective than a dose of steroids when patients had gone to urgent care clinics or emergency departments with acute symptoms and high eosinophil counts.
Researchers at King’s College London said the findings could be ‘game-changing’ in an area of medicine that had not changed in fifty years.
In the trial, patients having an asthma or COPD attack were randomly assigned to be treated with benralizumab injection and placebo tablets, standard of care with prednisolone 30mg daily for five days and placebo injection or both benralizumab injection and steroid.
After 28 days cough, wheeze, breathlessness and sputum were found to be better in patients who had received benralizumab.
After 90 days, there were four times fewer people in the benralizumab group that failed treatment compared with just prednisolone, they reported in The Lancet Respiratory Medicine.
The researchers also found that treatment with benralizumab ‘took longer to fail’, meaning fewer visits to a GP or hospital.
There was also an improvement in the quality of life for people with asthma and COPD, they added.
Almost three quarters (74%) of patients who received standard of care prednisolone needed further treatment within 90 days which highlights the poor outcomes seen currently with short-course steroids when treating eosinophilic exacerbations, they concluded.
Benralizumab injections could potentially be given in the GP practice or in the emergency department, they added.
It comes as last week the new NICE/BTS/SIGN joint guidelines on management of asthma were finally published.
Study leader, Professor Mona Bafadhel director of the King’s Centre for Lung Healthsaid: ‘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.
She added that the big advance in the study was the finding that targeted therapy works in asthma and COPD attacks.
‘Instead of giving everyone the same treatment, we found targeting the highest risk patients with very targeted treatment, with the right level of inflammation was much better than guessing what treatment they needed.’
Dr Samantha Walker, director of research and innovation, at Asthma + Lung UK, said: ‘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 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.’
