Health
July 31, 2024

Promising results shown in severe asthma study

King's College professor has revealed promising outcomes in managing severe asthma.

Brandon Foster
by 
Brandon Foster

Introduction

A recent study led by a professor at King's College has revealed promising outcomes in managing severe asthma using biologic therapies. This approach potentially eliminates the necessity for high-dose inhaled steroids, known for their significant side effects. Published in The Lancet[1], the SHAMAL study showed impressive results. Nearly 92% of patients treated with benralizumab, a biologic therapy, successfully reduced their inhaled steroid dosage. Moreover, over 60% of these individuals ceased using inhaled steroids completely.

Young boy using inhaler nebuliser.

Breakthrough treatment offers hope and relief

This breakthrough has the potential to drastically improve the lives of severe asthma patients by minimising or eradicating the adverse effects linked to inhaled steroids, such as osteoporosis, diabetes, and cataracts. Asthma affects around 300 million people globally, with 3 to 5% experiencing severe asthma, leading to daily symptoms like breathlessness, chest tightness, coughing, and recurrent asthma attacks requiring frequent hospital visits.

Led by Professor David Jackson, who oversees the Severe Asthma Centre at Guy's & St. Thomas' NHS Trust and serves as a Professor of Respiratory Medicine at King's, the SHAMAL study employed benralizumab. This biologic therapy reduces inflammatory cell counts, particularly eosinophil, which is crucial in the airways of severe asthma patients. It's administered via injection every four to eight weeks and available at specialised NHS asthma centres.

This comprehensive research spanned 22 countries including the UK, France, Italy, and Germany sites. In the study, 208 patients were randomly assigned to taper their high-dose inhaled steroid levels over 32 weeks, followed by a 16-week maintenance phase. Almost 90% of patients experienced no deterioration in asthma symptoms and remained free of exacerbations during the 48-week study period. Further investigations akin to the SHAMAL study are vital before firmly advocating reducing or halting high-dose steroid usage with other biologic therapies. Funded by AstraZeneca, the study involved researchers from esteemed universities such as Queens University Belfast, Université Paris-Saclay, and Trinity College Dublin.

  • Asthma, a chronic respiratory condition, manifests with symptoms such as wheezing, breathlessness, chest tightness, and coughing due to inflammation and airway constriction.
  • Common triggers like allergens (e.g., pollen, dust mites, pet dander), respiratory infections, air pollutants, and physical activity can provoke asthma attacks.
  • Treatment typically involves bronchodilators and inhaled corticosteroids to effectively control symptoms and prevent exacerbations.
  • Effective asthma management includes identifying and avoiding triggers, regular monitoring of lung function, and having an action plan ready to address flare-ups promptly.
  • Collaborating with healthcare professionals is crucial for developing personalised asthma management strategies tailored to individual needs and circumstances.
“Effective asthma treatment isn't just about managing symptoms; it's about empowering each asthma sufferer to be able to breathe freely and live their best life to the full”

Conclusion

The recent SHAMAL study, led by Professor David Jackson of King's College, has unveiled promising prospects in managing severe asthma through biologic therapies. This breakthrough, showcased in The Lancet, demonstrates the potential to reduce or eliminate the need for high-dose inhaled steroids, known for their adverse effects. With nearly 92% of patients treated with benralizumab successfully reducing their steroid dosage and over 60% ceasing steroid use entirely, this advancement offers hope for improving the quality of life for severe asthma sufferers. Moving forward, further research and exploration of similar biologic therapies are crucial to solidify these findings and expand treatment options for asthma patients worldwide.

Reference:

  1. Reduction of daily maintenance inhaled corticosteroids in patients with severe eosinophilic asthma treated with benralizumab (SHAMAL): a randomised, multicentre, open-label, phase 4 study. Prof David J Jackson PhD, Prof Liam G Heaney MD, Prof arc Humbert MD, Brian D. Kent MD, Anat Shavit DVM, Lina Hiljemark BPharm, et al. Published: December 07, 2023. DOI: https://doi.org/10.1016/S0140-6736(23)02284-5.

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