The monoclonal antibody benralizumab, which is currently used in the treatment of severe asthma, could help to treat exacerbations in asthma and COPD, according to a new UK trial.
Benralizumab 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. This reduced the need for further treatment and hospitalisations.
Researchers at King’s College London said the findings could be ‘game-changing’ in an area of medicine that had not changed in 50 years.
In the trial, patients having an asthma or COPD attack were randomly assigned into three groups. The first was treated with a benralizumab injection and placebo tablets, the second received the standard of care of prednisolone 30mg daily for five days plus a placebo injection, and the third received both a benralizumab injection and the standard of care prednisolone.
After 28 days cough, wheeze, breathlessness and sputum were found to be better in patients who had received benralizumab and after 90 days, there were four times fewer people in the benralizumab group that failed treatment compared with those who only received prednisolone.
Writing in The Lancet Respiratory Medicine, the researchers also noted 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.
Almost three quarters (74%) of patients who received standard of care prednisolone needed further treatment within 90 days, highlighting the poor outcomes currently seen with short-course steroids when treating eosinophilic exacerbations, they concluded.
The safety profile of benralizumab injections was similar to previous studies and the researchers said it could potentially be given in a GP practice or emergency department.
Eosinophilic exacerbations make up to 30% of COPD flare-ups and almost 50% of asthma attacks, with two million exacerbations of this type in the UK per year.
Study leader Professor Mona Bafadhel, director of the King’s Centre for Lung Health, said: ‘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 advancement in this study was discovering 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,’ she said.
Dr Samantha Walker, director of research and innovation, at the charity 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.’
The publication of this research comes as the long-awaited NICE/BTS/SIGN joint guidelines on management of asthma were launched.
In November, a report revealed that a digital asthma tool could reduce emergency appointments and save NHS £25m annually.
A version of this article was originally published by our sister publication Pulse.
