There may be a more effective treatment for severe asthma and chronic obstructive pulmonary disease (COPD) attacks than that used as the standard of care for 50 years, according to a recent study.
Researchers at King’s College London and Oxford University found injections of a drug called Fasenra can be more effective than the oral corticosteroid prednisolone when injected during an attack and cut the need for further treatment by 30 per cent.
“This could be a game-changer for people with asthma and COPD,” Professor Mona Bafadhel from King’s College London, who led the trial, said of her team’s findings this week.
Asthma and COPD exacerbations cause nearly four million deaths worldwide each year, but treatment for the chronic conditions has not changed in five decades, she noted.
The attacks — which can involve symptoms such as wheezing, coughing and chest tightness — can become more frequent as the disease progresses.
Many patients who suffer these attacks need repeated courses of steroids, re-hospitalisation or die within 90 days, the researchers said.
Steroids such as prednisolone can reduce inflammation in the lungs but sometimes cause severe side effects.
Benralizumab vs steroids
The active ingredient of Fasenra — made and marketed by the Anglo-Swedish drugmaker AstraZeneca, which partly funded the study — is a chemical known as benralizumab.
The study, published in The Lancet Respiratory Medicine journal, showed that those treated with benralizumab experienced significant improvements in respiratory symptoms after 28 days and had lower treatment-failure rates after 90 days compared to the steroids group.
The findings show that the AstraZeneca drug can also be used during the emergency of a life-threatening attack, at a hospital or potentially even at home, to reduce the need for further treatment and hospitalisations, researchers said.
Benralizumab targets a type of white blood cell associated with lung inflammation and was approved by United States and European Union regulators in 2017 as an antibody treatment for severe eosinophilic asthma.
It’s typically administered in low doses for ongoing treatment but the recent trial revealed that a single higher dose given during a flare-up could provide significant, long-term benefits.
Fasenra is AstraZeneca’s second-best-selling drug from its respiratory and immunology portfolio and brought in 669 million in sales in the third quarter of 2024, up 13 per cent from a year earlier.
Study highlights bigger problems
John Blakey, a medical advisor to Asthma Australia, said the study results were promising but highlighted a bigger problem with how Australia treats asthma and COPD.
“In Australia, asthma and COPD care is disjointed. There is not a general coherent system of care with clear pathways including expert centres. It’s a national problem that needs state and national solutions,” he said.
“We haven’t changed our “one size fits all” approach to exacerbations in 50 years, yet these exacerbations can be caused by multiple factors such as viruses, pollution and allergies so it makes more sense to have a targeted approach.
“Our current health services are set up and reimbursed largely to treat acute illness. With the array of effective newer treatments available we can accomplish a lot more through prevention.”
With additional reporting by Reuters.