Severe, poorly controlled asthma can increasingly be treated with monthly injections.
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People with severe asthma sometimes rely on daily steroids, which increases the risk of diabetes, infections and bone problems. The study now supports the idea that a monthly antibody injection is a safer alternative.
Asthma that is not controlled by inhalers can be treated with steroid tablets, which are effective in reducing inflammation in the airways, reducing symptoms and the risk of an asthma attack, but have serious side effects. “We'd like to encourage people to get off oral steroids as much as possible,” says Fan Chung at Imperial College London, which was not involved in the study.
Previous studies have shown that tezepelumab (a monthly antibody injection) reduces symptoms of severe asthma better than a placebo injection. This has led to its approval in dozens of countries, including the UK and US, over the past few years. But it was unclear whether the drug could reduce or even eliminate the need for steroid pills.
To study this, David Jackson at Guy's and St Thomas' Hospital in London and his colleagues recruited 298 people with severe asthma aged 18 to 80 years from 11 countries. Participants who took daily inhalers and steroid tablets were asked to also take tezepelumab for one year. A control group was not necessary because trials had already shown that the injections provided benefits beyond the placebo effect, Chang says.
The researchers found that participants' doses of oral steroids were gradually reduced over the course of the study under medical supervision.
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 dosage to a level where there were “minimal side effects,” Chang says. “This is a very successful result,” he says. “The study confirms that tezepelumab is a useful treatment for patients with severe asthma, reducing their need for daily pills.”
Side effects, such as worsening asthma symptoms, were observed in 9 percent of participants, but it is unclear whether they were caused by the injections or would have happened anyway, Chang says. Either way, it's a reasonable share given the potential benefits of quitting steroid pills, he says.
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