Benralizumab shows dramatic results in COPD, asthma cases

Image of medical professional holding a stethoscope up to a graphic of lungs.

A new study into what researchers said could be a “game changing” treatment for people with asthma and COPD has shown effectiveness against eosinophilic exacerbations, which make up 30% of COPD flare-ups and almost 50% of asthma attacks.

The results, published in The Lancet Respiratory Medicine, come from the phase two clinical trial ABRA study, led by researchers from King’s College London and sponsored by the University of Oxford. Researchers said in a news release the study showed that benralizumab, which is already used to treat severe asthma, can be repurposed in emergency settings to reduce the need for further treatment and hospitalizations.

Benralizumab is a monoclonal antibody that targets specific white blood cells called eosinophils to reduce lung inflammation. The ABRA trial found that a single dose can be more effective when injected at the point of exacerbation compared to steroid tablets.

The trial participants, who were at high risk for an asthma or COPD attack, were assigned to three random groups: one received a benralizumab injection and dummy tablets, one received standard of care (30 mg of prednisolone daily for five days) and a dummy injection, and one received both benralizumab injections and standard of care.

After 28 days, respiratory symptoms — including coughing, wheezing, breathlessness and sputum — were found to be better in patients who received benralizumab. After 90 days, the benralizumab treatment failed at a rate four times less than the standard of care treatment with prednisolone. Researchers said this meant the benralizumab treatment lasted longer, and therefore that group required fewer trips to the doctor or the hospital.Kaplan–Meier plot of time to first treatment failure event in the PRED and pooled-BENRA treatment groupsKaplan–Meier plot of time to first treatment failure event in the prednisolone and pooled benralizumab treatment groups.https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(24)00299-6/fulltext

“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 exacerbation — to show that it’s more effective than steroid tablets, which is the only treatment currently available,” said lead investigator Mona Bafadhel, chair of Respiratory Medicine and director of the King’s Center for Lung Health at King’s College London. “The big advance in the ABRA study is the finding that targeted therapy works in asthma and COPD attacks. Instead of giving everyone the same treatment, we found targeting the highest risk patients with very targeted treatment, with the right level of inflammation, was much better than guessing what treatment they needed.”

In the study, health care professionals administered the benralizumab injections, but researchers said the injections can also be administered safely at home, in a doctor’s office or in the emergency department. Benralizumab was found to be safe in the study and similar in safety to many past studies.

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