Major breakthrough for severe asthma treatment


    A landmark study has shown that severe asthma can be controlled using biological therapies without the addition of regular high-dose inhaled steroids, which can have significant side effects

King's College London

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A groundbreaking study has revealed that effective control of severe asthma is possible through the use of biological therapies, eliminating the need for regular high-dose inhaled steroids that often come with significant side effects.

   A groundbreaking multinational study, known as the SHAMAL study and published in The Lancet, has revealed promising results in managing severe asthma using the biological therapy benralizumab . The study demonstrated that 92% of patients treated with benralizumab  could safely reduce their inhaled steroid dose, with more than 60% able to cease usage completely.

These findings carry significant implications for individuals with severe asthma, offering a potential means to minimize or eliminate the adverse effects associated with regular high-dose inhaled steroids. Such side effects include conditions like osteoporosis, which increases the risk of fractures, as well as diabetes and cataracts.

Affecting nearly 300 million people worldwide, asthma is a prevalent respiratory condition, with 3 to 5% of these individuals experiencing severe asthma. Severe asthma entails daily symptoms such as breathlessness, chest tightness, and coughing, often leading to frequent hospitalizations due to asthma attacks.

The SHAMAL study, led by Professor David Jackson, head of the Severe Asthma Centre at Guy's and St Thomas' and Professor of Respiratory Medicine at King's College London, focused on benralizumab,  a biologic therapy designed to reduce the number of inflammatory cells called eosinophils. These cells, found in abnormal quantities in the airways of severe asthma patients, play a crucial role in developing asthma attacks.

Administered through injections every four to eight weeks, benralizumab  is available in specialist NHS asthma centers. The study involved 208 patients across 22 UK, France, Italy, and Germany sites. Patients were randomly assigned to taper their high-dose inhaled steroid over 32 weeks, followed by a 16-week maintenance period. Approximately 90% of patients experienced no worsening of asthma symptoms and remained free of exacerbations throughout the 48-week study.

While the results of the SHAMAL study are promising, further research will be essential to solidify recommendations regarding the safety and efficacy of reducing or eliminating high-dose steroid use with other biological therapies. The study received funding from AstraZeneca and involved researchers from esteemed institutions, including Queen's University Belfast, Université Paris-Saclay, and Trinity College Dublin.

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