A new study published in The Lancet Respiratory Medicine indicates that benralizumab, a monoclonal antibody, could revolutionize the treatment of asthma and chronic obstructive pulmonary disease (COPD) exacerbations. The trial, led by researchers at King's College London, suggests that benralizumab is more effective than traditional steroid tablets in reducing respiratory symptoms and preventing treatment failures in patients experiencing flare-ups.
Targeting Eosinophilic Inflammation
Benralizumab targets eosinophils, a type of white blood cell that contributes to lung inflammation in approximately 50% of asthma attacks and 30% of COPD exacerbations. During these episodes, eosinophil levels surge in the lungs, leading to wheezing, coughing, and chest tightness. By selectively depleting eosinophils, benralizumab aims to reduce inflammation and alleviate symptoms.
ABRA Trial Results
The phase 2 ABRA trial involved 158 patients with asthma or COPD who were experiencing a flare-up. Participants were divided into three groups: one receiving benralizumab, another receiving prednisolone (a steroid), and a third receiving both. After 28 days, the benralizumab group showed greater improvement in respiratory symptoms compared to the prednisolone group. Moreover, after 90 days, the benralizumab group had four times fewer treatment failures, defined as the need for hospitalization, further treatment, or death.
According to Dr. Mona Bafadhel, lead researcher and chair of respiratory medicine at King's College London, "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. 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."
Improved Quality of Life and Reduced Side Effects
Patients receiving benralizumab also reported an overall improvement in their quality of life. Unlike steroids, benralizumab did not cause significant side effects such as increased risk of diabetes and osteoporosis. This is particularly important for patients who require frequent or long-term treatment for asthma and COPD.
Potential for At-Home Administration
While the injections were administered by healthcare professionals during the trial, researchers believe that benralizumab could potentially be given safely at home or in a doctor's office. This would greatly improve access to treatment and reduce the burden on healthcare systems.
Future Directions
Although the results of the ABRA trial are promising, further research is needed to confirm the efficacy and safety of benralizumab for asthma and COPD exacerbations. A larger phase 3 trial is planned to begin in 2025. If successful, benralizumab could become the first new therapy approved for eosinophilic exacerbations of asthma and COPD in over 50 years.
Dr. Sanjay Ramakrishnan, a clinical senior lecturer at the University of Western Australia, emphasized the urgent need for new treatments for COPD, stating, "COPD is the third leading cause of death worldwide but treatment for the condition is stuck in the 20th century. We need to provide these patients with life-saving options before their time runs out."
