End of the inhaler? Landmark study finds antibody injection can treat severe asthma

Majority of patients who used benralizumab were able to completely stop using their inhalers
Scientists on Monday hailed the breakthrough
PA
Daniel Keane11 December 2023

Scientists on Monday hailed a breakthrough for severe asthma treatment as a study found that the condition can be controlled by a regular injection of an antibody, eliminating the need for an inhaler.

The SHAMAL study, led by academics at King’s College London, found that 92 per cent of patients who used benralizumab were able to safely reduce use of their inhaler. Six in ten patients were able to completely stop all use.

Benralizumab is known as a biologic therapy, a type of treatment that boosts or restores the ability of the immune system to fight off diseases. It is injected every four to eight weeks and is available in specialist NHS asthma centres.

Around 160,000 people in the UK are diagnosed with asthma each year, according to the National Institute for Health and Care Excellence. It causes symptoms including breathlessness, chest tightness and cough, along with repeated asthma attacks which require hospitalisation.

The condition is often managed using an inhaler containing steroid medicine.

Researchers said the study’s results could be transformative for severe asthma patients by minimising or eliminating the unpleasant side effects of inhaled steroids. These include osteoporosis, which leads to an increased risk of fractures and diabetes.

David Jackson, Professor of Respiratory Medicine at King’s College London, said: “Biological therapies such as benralizumab have revolutionised severe asthma care in many ways, and the results of this study show for the first time that steroid related harm can be avoided for the majority of patients using this therapy.”

Doctors had previously advised using biologics in addition to an inhaler.

Benralizumab works by reducing the number of inflammatory cells called eosinophils, which are produced in abnormal numbers in the airway of patients with severe asthma.

There are three other approved biologic treatments for severe asthma: omalizumab, mepolizumab and reslizumab.

For the trial, scientists assessed 208 patients across 22 sites in four countries who gradually reduced use of their inhaler over the course of 32 weeks, followed by a 16-week maintenance period.

Approximately 90 per cent of patients experienced no worsening of asthma symptoms throughout the 48-week study.

However, experts have warned that it remains difficult for many patients to access biologic therapies on the NHS. It takes about a year on average from being referred to a severe asthma service to getting a biologic, according to Asthma and Lung UK.

Results from the SHAMAL study were published in The Lancet.

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