Severe, poorly-controlled asthma could increasingly be treated with a monthly injection
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Individuals suffering from severe asthma often rely on daily steroid pills to manage their condition. However, these pills come with potential risks such as diabetes, infections, and bone issues. A recent study suggests that a monthly antibody injection could be a safer and more effective alternative.
For individuals whose asthma is not adequately controlled with inhalers, steroid pills are often prescribed to reduce inflammation in the airways, thereby alleviating symptoms and lowering the risk of asthma attacks. However, the side effects associated with oral steroids are a cause for concern. “We’d like to reduce the reliance on oral steroids as much as possible,” says Fan Chung of Imperial College London.
Previous trials have demonstrated that tezepelumab, a monthly antibody injection, is more effective in alleviating symptoms of severe asthma compared to a placebo injection. This has led to the approval of the drug in numerous countries, including the UK and US. However, it remained unclear whether tezepelumab could eliminate the need for steroid pills altogether.
To address this question, David Jackson of Guy’s and St Thomas’ hospital in London and his team enrolled 298 individuals with severe asthma, ranging from 18 to 80 years old, from 11 different countries. These participants, who were already using daily inhalers and steroid pills, were instructed to incorporate tezepelumab into their treatment regimen for one year. Chung notes that a control group was unnecessary as previous trials had already established the benefits of the injections beyond a placebo effect.
The researchers observed a gradual reduction in the participants’ oral steroid doses over the course of the study, under the guidance of their healthcare providers.
At the conclusion of the study, approximately half of the participants no longer required any steroid pills, while 40% were able to significantly decrease their dosage to a level where the risk of side effects was minimal, according to Chung. He describes the outcomes as highly successful, confirming that tezepelumab is a valuable treatment option for individuals with severe asthma, reducing their reliance on daily steroid pills.
Although 9% of the participants experienced side effects such as worsening asthma symptoms, Chung suggests that it is unclear whether these were directly caused by the injections or would have occurred regardless. Nevertheless, he deems this proportion reasonable considering the potential benefits of discontinuing steroid pills.
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