London scientists have created a “game-changing” new treatment for asthma attacks that can reduce the need for further treatment by 30 per cent.
Benralizumab is the first treatment for asthma attacks and chronic obstructive pulmonary disease (COPD) in 50 years.
The drug, which is delivered by an injection, helps to treat flare-ups of the respiratory condition called “eosinophilic exacerbations”, which cause symptoms such as wheezing, coughing and chest tightness. These are responsible for half of all asthma attacks and become more frequent as the disease progresses.
Benralizumab is a monoclonal antibody, a man-made clone of a normal antibody produced by the immune system. It targets specific white blood cells, called eosinophils, to reduce lung inflammation.
The drug is already used as a repeat treatment for severe asthma at a low dose, but a trial led by King’s College London has found that a higher single dose can be effective if injected at the time of a flare-up.
Lead investigator of the trial, 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 fifty 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.”
The ABRA trial, carried out at Oxford University Hospitals NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust, randomised people at high risk of an asthma or COPD attack into three groups.
One group received a benralizumab injection and dummy tablets, one received standard of care (prednisolone 30mg daily for five days) and a dummy injection and the third received both a benralizumab injection and standard of care.
After 28 days, respiratory symptoms of cough, wheeze, breathlessness and sputum were found to be better in the group that received benralizumab.
And after ninety days, there were four times fewer people in the benralizumab group that failed treatment compared to standard of care with prednisolone.
Treatment with the benralizumab injection took longer to fail, meaning fewer episodes to see a doctor or go to hospital, researchers said.
There was also an improvement in the quality of life for people with asthma and COPD.
Prof Bafadhel added: “The big advance in the ABRA study is 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.”
The benralizumab injection was administered by healthcare professionals in the study but can be potentially administered safely at home, in the GP practice, or in the Emergency Department, researchers said.
Geoffrey Pointing, 77 from Banbury, who took part in the study, said: “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.
“I used to never sleep well the first night of taking steroids, but the first day on the study, I could sleep that first night, and I was able to carry on with my life without problems. I want to add that I'm just grateful I took part and that the everyone involved in the ABRA study are trying to give me a better life.”
The findings have been published in the Lancet Respiratory Medicine.
