Treatment for asthma and chronic obstructive pulmonary disease (COPD), which contributed to Sinead O'Connor's death last year, has been "stuck in the 20th century." But no longer, says Dr. Sanjay Ramakrishnan of the University of Western Australia, co-author of a study offering the first breakthrough treatment in 50 years for attacks from asthma and COPD, the third leading cause of death worldwide. It involves AstraZeneca's benralizumab, a monoclonal antibody that targets a type of white blood cell called eosinophils in order to ease lung inflammation.
It's typically used at multiple low doses to treat severe asthma. But in this trial, a single high dose given to patients in the midst of an attack resulted in better respiratory symptoms and quality of life than the standard method of care, per the Guardian. The trial followed 158 people for three months after they visited an emergency room for an attack. Those found to be suffering an eosinophilic exacerbation—an inflammatory lung response that occurs in 50% of asthma attacks and 30% of COPD attacks—were randomly split into three groups.
One was prescribed the standard care: 30mg prednisolone steroid tablets daily for five days, plus a placebo injection. A second group received the tablets and a benralizumab injection, while the third received the injection and placebo tablets. Those given benralizumab ultimately reported better respiratory symptoms and quality of life. They also had a lower rate of treatment failure—defined by the study as "composite of death, admission to hospital, and any need for re-treatment requiring systemic glucocorticoids or antibiotics"—at 45% versus 74% for the steroid group, per the BBC.
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Researchers say benralizumab appears to cut the need for further treatment by 30%, per the Guardian. It also lacks the potentially severe side-effects of steroids and could possibly be administered safely at home, researchers say. "This is a game-changer" that "will revolutionize how we treat people when they're really unwell," Mona Bafadhel, chair of respiratory medicine at King's College London and lead author of the study published Wednesday in Lancet Respiratory Medicine, tells the BBC. "No drug gets rid of asthma completely, but this is the nearest thing," adds a 55-year-old trial participant who had experienced three major asthma attacks in five years. "It's a bit of a miracle actually." A larger, two-year trial of benralizumab begins next year. (More asthma stories.)