Asthma: First new treatment for asthma attacks in 50 years

Researchers say they have found the first new treatment for asthma attacks in 50 years.

The injection dampens the part of the immune system that can increase flare-ups of both asthma and a lung condition called chronic obstructive pulmonary disease (COPD).

Benralizumab is already used in the most serious cases, but the latest research suggests it could be used routinely for around two million attacks in the UK each year.

The research team at King’s College London said the drug was a “game changer” that could “revolutionise” care.

The findings stem from the realization that not all asthma or COPD attacks are the same. Instead, different parts of the immune system are overreacting in different patients.

“Now we can see that there are different patterns of inflammation, we can be smarter and get the right treatment for the right patient at the right time,” said Professor Mona Bufadel from King’s.

Benralizumab targets a type of white blood cell – called an eosinophil – that can cause inflammation and damage in the lungs.

Eosinophils are involved in about half of asthma attacks and one-third of COPD flare-ups.

Doctors currently prescribe a course of steroids if such attacks – which include difficulty breathing, wheezing, coughing and chest tightness – cannot be controlled with a regular inhaler.

The study, on 158 people, monitored patients for three months after treatment.

The Lancet Respiratory Medicine results found treatment failure rates:

• 74% when taking steroids.
• and 45% with new therapy

People treated with the new therapy were less likely to be hospitalized, need a second round of treatment or die.

Professor Bufadel said this could benefit a large number of people as two million attacks a year “is not a small number”.

“This is a game changer, we’ve had no treatment changes for 50 years – it will revolutionize how we treat people when they’re really ill,” Professor Bufadel said.

Volunteers also reported better symptoms and better quality of life on the new drug.

Alison Spooner, 55, from Oxfordshire, was one of those who took part in the trial. He has had asthma since childhood, but in the past five years it has gotten worse and he has had three major attacks.

“They seemed to be getting worse, the severe shortness of breath when you’re gasping and there’s nothing to gasp for,” she told me.

Alison says she feels “absolutely different” after the injection and still uses her inhaler but “only because I’m told to”.

“Unfortunately, no medicine completely cures asthma, but this is the closest thing. It’s truly a miracle,” she adds.

Benralizumab is not ready for widespread use.

It will still take a larger trial, due to start in 2025 and lasting two years, for any benefit. Anyone who has already been prescribed these drugs should continue to follow their prescription.

The study will also have to assess cost-effectiveness because monoclonal antibodies, like this therapy, are expensive drugs.

But Dr Sanjay Ramakrishnan, from the University of Oxford, said the work so far “shows enormous promise” and that treating COPD, despite being one of the leading causes of death worldwide, ” was stuck in the 20th century”.

Long-term use of steroids is associated with side effects including weight gain, diabetes and weak bones.

Geoffrey Pointing, 77, from Oxfordshire, who also took part in the trial, said: “I didn’t get any side effects like I used to with steroid pills.

“I never slept well the first night of taking steroids, but on the first day of the study, I was able to sleep that first night, and I was able to go about my life without any problems.”

It is estimated that four people die every day from asthma and 85 from COPD in the UK.

Dr Samantha Walker, from the charity Asthma + Lung UK, said the findings were “very good news”.

“But it’s scary that this is the first new treatment for people with asthma and COPD attacks in 50 years.”