An injection given during some asthma and COPD attacks is more effective than the current treatment of steroid tablets, reducing the need for further treatment by 30%, according to a UK study. 

The findings, published in The Lancet Respiratory Medicine, could be “game-changing” for millions of people with asthma and COPD around the world, scientists say. 

The injection treats eosinophilic exacerbations, which involve symptoms such as wheezing, coughing and chest tightness due to inflammation resulting from high amounts of eosinophils. 

Eosinophilic exacerbations make up to 30% of COPD flare-ups and almost 50% of asthma attacks. 

Steroids such as prednisolone, the mainstay of treatment for the last 50 years, can reduce inflammation in the lungs but have severe side-effects such as diabetes and osteoporosis. Furthermore, many patients ‘fail’ treatment and need repeated courses of steroids, re-hospitalisation or die within 90 days. 

A “game-changer” for asthma and COPD

Results from the Phase II ABRA study, led by scientists from King’s College London and sponsored by AstraZeneca and the University of Oxford, show a drug already available can be re-purposed in emergency settings to reduce the need for further treatment and hospitalisations. 

Benralizamab is a monoclonal antibody which targets specific eosinophils to reduce lung inflammation. The ABRA trial has found a single dose can be more effective when injected at the point of exacerbation compared to steroid tablets. 

After 28 days, respiratory symptoms of cough, wheeze, breathlessness and sputum were found to be better with benralizumab. After ninety days, there were four times fewer people in the benralizumab group that failed treatment compared to standard of care with prednisolone. 

“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,” said lead investigator of the trial Professor Mona Bafadhel from King’s Centre for Lung Health 

“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 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.”

Diana Spencer, Senior Digital Content Editor, DDW