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Groundbreaking research offers a promising alternative to steroid treatments, providing new hope for millions.
A novel treatment for asthma and chronic obstructive pulmonary disease (COPD) attacks has been hailed as a potential game-changer after new clinical trial findings revealed it is more effective than the current standard of care. The treatment, an injection of the monoclonal antibody benralizumab, could reduce the need for further medical interventions by 30%, marking the first major breakthrough in asthma and COPD treatment in 50 years.
The study, published in The Lancet Respiratory Medicine, shows that benralizumab—currently used for severe asthma—can also be repurposed to treat acute exacerbations of asthma and COPD, offering significant benefits over the conventional use of steroid tablets like prednisolone. These exacerbations, which involve inflammation and symptoms such as wheezing, coughing, and chest tightness, can often be life-threatening, and the research points to benralizumab as a safer, more effective solution for many patients.
Asthma and COPD are widespread conditions that affect millions worldwide. In the UK alone, asthma attacks occur every 10 seconds, and COPD accounts for 85 deaths a day. Despite the prevalence of these conditions, the treatments for acute attacks have remained largely unchanged for decades. Steroid medications, while effective in reducing inflammation, come with a range of serious side effects, including diabetes and osteoporosis, and many patients experience repeated exacerbations that lead to hospitalization or death within months.
The Phase II ABRA clinical trial, led by researchers from King’s College London, focused on patients with eosinophilic exacerbations of asthma and COPD, which account for 30% of COPD flare-ups and nearly half of asthma attacks. These exacerbations are caused by high levels of eosinophils, a type of white blood cell that triggers inflammation in the lungs. By targeting these specific cells, benralizumab shows promising results in reducing inflammation more effectively than steroids.
The trial included three groups: one receiving benralizumab and a placebo tablet, another receiving standard steroid treatment with a placebo injection, and a third receiving both benralizumab and steroids. After 28 days, those in the benralizumab group showed significant improvements in respiratory symptoms, with four times fewer patients requiring additional treatment within 90 days compared to the steroid-only group.
Professor Mona Bafadhel, the lead investigator, described the results as “game-changing,” noting that benralizumab’s targeted approach to inflammation represents a major shift in how asthma and COPD flare-ups may be treated in the future. “Instead of giving everyone the same treatment, we focused on patients with high-risk exacerbations and tailored the treatment to their specific needs,” she explained.
The trial, conducted at Oxford University Hospitals NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust, also suggests that the injection, which is administered by healthcare professionals, could potentially be safely delivered at home, at GP practices, or in emergency departments.
Benralizumab’s promising results come at a time when asthma and COPD continue to contribute to a global health crisis. The World Health Organization reports that these conditions together are responsible for 3.8 million deaths annually. Despite this, treatment options for severe exacerbations have largely remained static for decades, with doctors relying on steroids to manage acute symptoms.
Dr. Sanjay Ramakrishnan, a clinical senior lecturer at the University of Western Australia and first author of the study, emphasized the importance of moving beyond outdated treatments. “COPD is the third leading cause of death worldwide, yet many of the treatments we use today are stuck in the 20th century,” he said. “The ABRA trial offers a beacon of hope for patients suffering from these debilitating diseases.”
Dr. Samantha Walker, Director of Research and Innovation at Asthma + Lung UK, echoed the excitement but also highlighted the need for greater funding in lung health research. “It’s fantastic news for people with lung conditions, but the fact that this is the first new treatment in 50 years highlights the chronic underfunding of lung health research,” she said. “Thousands of people live with the constant fear of struggling to breathe, and this breakthrough could be life-saving for many.”
The team behind the study hopes that these findings will spark a transformation in how asthma and COPD exacerbations are treated, improving the quality of life for millions around the world. With ongoing studies, researchers are optimistic that benralizumab will become a critical tool in managing acute asthma and COPD attacks and ultimately reducing the staggering global mortality rates associated with these conditions.
For more information, the full study can be accessed in The Lancet Respiratory Medicine (2024).
