Benralizumab

A UK study has shown that a drug currently used to treat severe asthma could be re-purposed for use in emergency settings, potentially representing the first new treatment for asthma attacks in 50 years. The phase 2 ABRA study, led by scientists from King’s College London and sponsored by the University of Oxford, found that a single dose of AstraZeneca’s benralizumab could be more effective when injected at the point of exacerbation compared to currently used steroid tablets. The trial randomised patients at high risk of an asthma or chronic obstructive pulmonary disease (COPD) attack to receive benralizumab injection, standard-of-care prednisolone, or benralizumab plus prednisolone. Results published in The Lancet Respiratory Medicine showed that respiratory symptoms of cough, wheeze, breathlessness and sputum were found to be better with benralizumab after 28 days, and that four times fewer patients in the benralizumab group failed treatment compared to prednisolone after 90 days. The research, conducted with support from AstraZeneca UK, also showed that treatment with benralizumab took longer to fail, meaning fewer visits to a doctor or hospital for patients, and the drug was associated with an improvement in quality of life. Benralizumab is already authorised under the brand name Fasenra as a maintenance treatment for severe eosinophilic asthma and is designed to target specific white blood cells called eosinophils. More than one billion people globally are affected by asthma and COPD, a chronic respiratory disease, with eosinophilic exacerbations accounting for up to 30% of COPD flare-ups and almost 50% of asthma attacks. Steroids such as prednisolone can reduce inflammation in the lungs but have severe side effects, such as diabetes and osteoporosis, and many patients fail treatment. Lead investigator of the trial, Mona Bafadhel, King’s Centre for Lung Health said the findings could be a “game changer for people with asthma and COPD”. She said: “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.” The researchers are now hoping to launch a two-year phase 3 trial of the drug in 2025.

THURSDAY, Nov. 28, 2024 -- Geoffrey Pointing says its hard to describe the distress of an asthma or COPD flare-up. “Honestly, when you're having a flare up, it's very difficult to tell anybody how you feel - you can hardly breathe,” Pointing, 77, of Banbury, England, said in a news release. But an existing injectable drug might make these attacks much less frightening, a new clinical trial has shown. The already-approved drug for asthma could replace steroid medications as a means of quelling asthma and COPD flare-ups, researchers report. Benralizabam, a monoclonal antibody, did a better job than steroids at reducing respiratory symptoms like coughing, wheezing, breathlessness and hacking up phlegm, according to trial results published in The Lancet Respiratory Medicine. After three months of treatment, four times fewer people taking benralizumab had suffered an asthma or COPD attack, compared to people taking the steroid prednisolone. “This could be a game-changer for people with asthma and COPD,” said lead researcher Dr. Mona Bafadhel , chair of respiratory medicine for King’s College London. “Treatment for asthma and COPD exacerbations have not changed in fifty years despite causing 3.8 million deaths worldwide a year combined,” Bafadhel continued in a news release. “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.” Pointing, who participated in the trial, called the drug “fantastic.” “I didn't get any side effects like I used to with the steroid tablets,” he said. “I used to never sleep well the first night of taking steroids, but the first day on the study, I could sleep that first night, and I was able to carry on with my life without problems.” Benralizumab targets specific white blood cells called eosinophils, which contribute to lung inflammation. The U.S. Food and Drug Administration approved it in 2017 for the management of severe asthma, but this trial aimed to test its effectiveness in dealing with asthma and COPD attacks. Eosinophilic exacerbations make up 30% of COPD flare-ups and nearly 50% of asthma attacks, researchers said. During these episodes, amounts of the white blood cells surge in the lungs, causing wheezing, coughing and chest tightness. For the clinical trial, researchers divided asthma or COPD patients into one of three groups – one receiving benralizumab during a flare-up, another taking prednisolone tablets, and a third receiving both benralizumab and prednisolone. The benralizumab group not only had fewer symptoms, but it also took longer for them to suffer an event so severe they had to either see a doctor or go to the hospital, researchers found. People given the injections also had an overall improvement in their quality of life, researchers added. The injections were administered by health care professionals during the trial, but could potentially be given safely at home or in a doctor’s office, researchers said. “Our study shows massive promise for asthma and COPD treatment,” lead researcher Dr. Sanjay Ramakrishnan , a clinical senior lecturer at the University of Western Australia, said in a news release. “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.” The clinical trial was supported by benralizumab’s manufacturer, AstraZeneca. Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.