every 30 secondssomeone on the earth will experience a flare-up of their asthma or chronic obstructive pulmonary disease (COPD) symptoms. For many years, the usual treatment for these potentially life-threatening episodes has remained unchanged – treatment with steroids, akin to prednisolone.
Unfortunately, these medications don't work for everybody and have significant levels of significant unintended effects. About one-third of patients treated with steroids will experience a relapse of symptoms inside a month, requiring further treatment and Increased risk of unintended effects.
But what if there was a greater option?
our Latest studyA drug called benralizumab – given as an injection – may very well be the breakthrough we've been waiting for, a study published in The Lancet Respiratory Medicine has revealed. The results suggest that this treatment, given on the time of a flare-up, is very effective and protects patients from the unintended effects of steroids.
Inflammation attributable to a kind of white blood cell called eosinophils is a serious trigger of flare-ups in many individuals with asthma and a few individuals with COPD. Eosinophilic inflammation contributes to not less than half of asthma and one-third of COPD exacerbations. For these people, targeting eosinophils is a promising strategy when symptoms worsen.
Benralizumab, a monoclonal antibody, is already used for long-term management of eosinophilic asthma, with studies still evaluating the results of long-term management in eosinophilic COPD. However, the power to administer critical moments, when symptoms suddenly worsen, has not been studied before.
In the trial, 158 patients with asthma or COPD exacerbations were recruited from two UK hospitals. Participants were randomly assigned to one in all three groups: standard treatment with prednisolone tablets, an injection of benralizumab alone, or a mix of the 2.
Sonnis Photography/Shutterstock
Surprising results
The most important final result we were taken with was the “treatment failure rate,” defined as the necessity for further treatment, hospitalization, or death inside 90 days.
The results were striking: 74 percent of those treated with prednisolone alone experienced treatment failure inside 90 days. The failure rate dropped to 47% with benralizumab alone and 42% with combination therapy.
Pooled data from the benralizumab-treated groups showed that only 45% of patients experienced treatment failure, compared with 74% within the prednisolone group. For every 4 patients treated with benralizumab, one treatment failure was prevented.
The advantages of benralizumab have gone beyond the treatment failure rate. Patients treated with benralizumab reported faster recovery of symptoms and higher quality of life. For example, patients were in a position to breathe higher and had less pain.
Benralizumab also had a greater safety profile than prednisolone. Side effects commonly related to prednisolone, akin to high blood sugar, were absent in patients who received benralizumab alone.
This makes the treatment especially promising for individuals who face significant risks from repeated prednisolone use, akin to older adults and people with diabetes or osteoporosis.
Although low doses of benralizumab are already approved for long-term asthma management, the dose utilized in this study shouldn't be yet licensed to be used during flare-ups. For this to occur, phase 3 trials, involving a more diverse and international population, might be needed. (Phase 3 is the ultimate phase of human testing before a drug is approved.)
If these trials confirm the outcomes, benralizumab could change into the primary recent therapy approved for eosinophilic exacerbations of asthma and COPD in 50 years.
In the time it has taken you to read this text, 40 people on the earth have experienced a flare-up of eosinophilic asthma or COPD. Under the present best treatment, 30 of them would want further care inside 90 days. Benralizumab offers the potential to interrupt this cycle of repeated treatments and unintended effects, changing the way in which we manage these common and debilitating conditions.
Could this drug be the breakthrough we've been waiting for? Preliminary evidence suggests it might.