For the first time in 50 years, a new treatment has been found to improve care for people experiencing asthma or COPD (chronic obstructive pulmonary disease) attacks.
A drug called benralizumab, already used for severe asthma, was shown to work better than traditional steroid tablets during flare-ups.
This discovery, published in The Lancet Respiratory Medicine, could save lives and change how asthma and COPD are managed worldwide.
Asthma and COPD flare-ups, known as exacerbations, can be deadly. In the UK alone, four people with asthma and 85 people with COPD die every day.
These conditions are extremely common, and exacerbations can lead to irreversible lung damage if not treated properly.
Steroid tablets like prednisolone have been the standard treatment for over 50 years.
While they reduce inflammation, they come with serious side effects, such as diabetes and osteoporosis. Additionally, many patients do not respond well to steroids, requiring repeat hospital visits or risking death within 90 days of treatment.
The ABRA trial, led by researchers from King’s College London and other universities, tested benralizumab as an alternative to steroid tablets.
Benralizumab is a monoclonal antibody that targets eosinophils, a type of white blood cell that causes inflammation during certain asthma and COPD attacks.
These attacks, known as eosinophilic exacerbations, account for up to 50% of asthma and 30% of COPD flare-ups.
In the trial, 211 participants at high risk of asthma or COPD exacerbations were divided into three groups. One group received a benralizumab injection and placebo tablets, another received steroid tablets and a placebo injection, and the third group received both benralizumab and steroids. The trial was double-blind, meaning neither the participants nor the researchers knew which treatment was given.
After 28 days, people treated with benralizumab had fewer symptoms, like wheezing and breathlessness, compared to those who received steroids. After 90 days, the benralizumab group had four times fewer treatment failures and fewer hospital visits. Participants also reported a better quality of life.
Unlike steroids, benralizumab is a targeted therapy, meaning it specifically addresses the inflammation caused by eosinophils. This approach is safer and more effective for high-risk patients. The drug is already widely used and has a strong safety record, making it easier to integrate into emergency care.
The injection can be given by healthcare professionals in hospitals, GP clinics, or even at home, making it a flexible option for treating asthma and COPD attacks.
Professor Mona Bafadhel, the lead researcher, called the findings a “game-changer” for people with asthma and COPD. She emphasized the need for targeted therapies to improve care for the millions of people affected worldwide.
Dr. Samantha Walker from Asthma + Lung UK highlighted the importance of funding lung research. “It’s appalling that this is the first new treatment in 50 years,” she said. “With more research, we can transform the future for everyone struggling with lung conditions.”
This breakthrough offers hope for better treatments and outcomes for the over one billion people living with asthma and COPD globally.
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