Individuals grappling with asthma or chronic obstructive pulmonary disease (COPD) may soon breathe a sigh of relief thanks to recent advancements in therapy. A major clinical trial has revealed that an innovative antibody drug, benralizumab, shows remarkable promise in preventing and alleviating severe asthma and COPD flare-ups, even surpassing the current standard treatment used in managing these conditions.

Carried out by a team of scientists across the UK, Australia, and Sweden, this phase II trial employed a double-blinded, controlled, and randomized methodology to evaluate the effectiveness of benralizumab in treating acute asthma or COPD attacks. Participants who were at a heightened risk for these episodes were assigned to receive either steroids, the conventional first-line treatment, or a single injectable dose of benralizumab—administered either alone or in conjunction with steroids. The results were telling: individuals treated with benralizumab were significantly less likely to require additional interventions or hospitalizations compared to those on steroids alone.

Benralizumab, an engineered antibody from AstraZeneca, specifically targets and reduces eosinophils—certain white blood cells that play a dual role in combating infections and triggering asthma symptoms when their levels are elevated. This medication received FDA approval in 2017 as a supplemental treatment for severe eosinophilic asthma, but researchers are now exploring its potential in managing various forms of asthma and COPD primarily driven by high eosinophil counts.

Asthma and COPD patients frequently endure acute episodes characterized by exacerbated symptoms, which can include wheezing, persistent coughing, and difficulty breathing. If not managed adequately, these flare-ups can lead to irreversible lung damage and increase the risk of severe health crises. Currently, steroids are commonly prescribed to mitigate these episodes, but they are not always effective, often resulting in treatment failures. Moreover, steroid use carries risks of significant side effects, such as weight gain and a heightened risk of chronic complications, including type 2 diabetes. Given that eosinophils are implicated in about one-third of COPD exacerbations and nearly half of asthma attacks, the advent of benralizumab could revolutionize how these conditions are managed.

In the trial, 158 participants who had recently suffered a flare-up were divided into three treatment groups: one receiving a five-day course of the steroid prednisolone, another receiving benralizumab alone, and a third receiving both treatments simultaneously. Over the course of 28 days, those administered with benralizumab reported a marked improvement in symptoms and overall quality of life. A 90-day follow-up indicated that only 45% of the benralizumab group experienced treatment failure as opposed to 74% in the steroid group. Additionally, patients on benralizumab enjoyed longer periods without treatment failure, resulting in fewer medical consultations and fewer trips to the hospital.

While the findings published in The Lancet Respiratory Medicine bring great optimism, it is essential to note that phase II trials, though promising, are not conclusive. Additional larger-scale studies will be necessary to further validate the efficacy of benralizumab in managing severe asthma and COPD cases. However, if proven effective, this therapy could signify a groundbreaking advancement for countless individuals living with chronic respiratory conditions.

Encouragingly, given that benralizumab has already been utilized to treat other eosinophil-related conditions, its transition to address acute asthma and COPD flare-ups may occur more swiftly. Just this year, the FDA expanded its approval for benralizumab for young children with severe asthma, underscoring the drug’s potential as a transformative solution in respiratory medicine.