Severe, poorly controlled asthma could increasingly be treated with a monthly injection
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People with severe asthma sometimes have to take steroid pills daily, which increases the risk of diabetes, infections and bone problems. Now, a study supports the idea that a monthly antibody injection is a safer alternative.
Asthma that is not controlled by inhalers can be treated with steroid pills, which are effective in reducing inflammation in the airways – thereby reducing symptoms and the risk of an asthma attack – but have serious side effects. “We would like people to move away from oral steroids as much as possible,” says Fan Chung of Imperial College London, who was not involved in the study.
Previous trials have shown that tezepelumab, a monthly antibody injection, reduces severe asthma symptoms better than a placebo injection. This has led to its approval in dozens of countries, including the United Kingdom and the United States, in recent years. But it was unclear whether the drug could reduce, or even eliminate, the need for steroid pills.
To explore this, David Jackson from Guy and St Thomas’ Hospital in London and colleagues recruited 298 people with severe asthma, aged 18 to 80, from 11 countries. The participants, who took daily steroid inhalers and pills, were also asked to take tezepelumab for a year. A control group was not necessary because trials have already shown that the injections provide benefits beyond the simple placebo effect, Chung says.
The researchers found that participants’ doses of oral steroids were gradually reduced over the course of the study, under the supervision of their doctors.
By the end of the year, about half of the participants no longer needed steroid pills, and 40 percent of them were able to reduce their dose to a level where “side effects will be minimal,” Chung says. “It’s a very positive result,” he said. “The trial confirms that tezepelumab is a useful treatment for severe asthma patients, reducing their need for daily pills. »
Side effects, such as worsening asthma symptoms, were seen in 9% of participants, but it’s unclear whether these were caused by the injections or would have happened anyway, Chung says. Regardless, it’s a reasonable proportion considering the potential benefits of stopping steroid pills, he says.
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