Severe asthma can be controlled by a monthly injection, trial finds | Asthma

A monthly injection could allow people with severe asthma to stop taking daily steroid tablets, a clinical trial suggests.

It is estimated that more than 260 million people suffer from asthma worldwide. While most can control their asthma with inhalers to treat immediate symptoms and preventative symptoms to reduce inflammation, people with the most severe asthma often also take daily doses of oral corticosteroids.

But long-term use is associated with serious health problems, including osteoporosis, diabetes and increased vulnerability to infections.

Now, an international clinical trial found that participants who received tezepelumab injections every four weeks were able to reduce, or even completely stop, their steroid use without any adverse effects.

Tezepelumab, also known as Tezspire and manufactured by AstraZeneca, binds to and blocks a protein associated with airway inflammation.

The National Institute for Health and Care Excellence approved the drug in 2023 as an additional maintenance treatment for patients aged over 12 whose usual medications do not control their asthma well.

The Wayfinder trial, led by Kings College London, involved just under 300 adults with severe, uncontrolled asthma who took 5 to 40 mg of steroid tablets daily.

The patients, from 11 countries including the UK, US, France, Germany, Mexico and Spain, received tezepelumab monthly.

After a year of treatment, more than half of the participants had stopped taking their steroids completely without their asthma worsening, while almost 90% had reduced their steroid use to a low dose. A third had stopped taking steroids after six months.

Symptoms of asthma include coughing, wheezing, shortness of breath and chest tightness. Up to 10% of asthmatics suffer from serious illness and, in the most extreme cases, it can be fatal.

The trial results, published in The Lancet Respiratory Medicine and presented at the winter meeting of the British Thoracic Society, also showed that tezepelumab significantly improved asthma symptoms, lung function and overall quality of life. During the study, two-thirds of patients did not have any asthma attacks.

Lead author of the study, Professor David Jackson, expert in respiratory medicine at King’s College London and clinical lead for asthma services at Guy’s and Royal Brompton hospitals, said: “As tezepelumab also suppresses allergy-related symptoms and also improves chronic rhinosinusitis, the results are of particular interest for patients with severe asthma who suffer from upper and lower respiratory symptoms. »

Responding to the findings, Dr Samantha Walker, Director of Research and Innovation at Asthma + Lung UK, said: “This is an incredibly encouraging development for the future of asthma care which could transform the lives of people with severe asthma.

“It is vital that research into new types of treatment continues, but we know that current funding for lung health research is dedicated to sustaining life, even though lung disease remains the third leading cause of death in the UK. Studies like this show the positive impact that research can have in providing potentially life-changing treatment for people with asthma and other lung diseases.”

Professor Kamila Hawthorne, president of the Royal College of GPs, said: “Any new interventions that could help patients manage their symptoms more easily and safely and effectively would be welcomed.

“The prospect of a monthly injection, rather than daily tablets, may also be a more manageable treatment option for some patients.

“As with any emerging research, it is important that the findings are carefully evaluated and considered as clinical guidelines, which GPs use in their daily practice, are developed and updated, based on the latest evidence to ensure safety and benefit for patients.