A clinical trial has found that a monthly injection could allow people with severe asthma to stop taking daily steroid pills.
More than 260 million people worldwide are believed to suffer from asthma. While most people can control their asthma with inhalers to treat immediate symptoms and preventive measures to reduce inflammation, people with the most severe asthma often also take daily doses of oral corticosteroids.
But long-term use is linked to serious health conditions, including osteoporosis, diabetes and increased susceptibility to infection.
Now an international clinical trial has found that participants who received injections of tezepelumab every four weeks were able to reduce or stop taking their steroids altogether without any side effects.
Tezepelumab, also known as Tezspire and made by AstraZeneca, binds to and blocks proteins associated with airway inflammation.
The National Institute for Health and Care Excellence approved this drug in 2023 as additional maintenance treatment for patients over the age of 12 whose usual medication does not control their asthma well.
The WAYFINDER trial, led by King’s College London, involved just under 300 adults with severe, uncontrolled asthma who were taking 5mg-40mg steroid tablets daily.
Tezepelumab was given every month to patients in 11 countries, including the UK, US, France, Germany, Mexico and Spain.
After one year of treatment, more than half of the participants had completely stopped taking their steroid medication without asthma worsening, while nearly 90% had reduced their steroid use to lower doses. One third had stopped taking steroids after six months.
Symptoms of asthma include coughing, wheezing, shortness of breath and chest tightness. Up to 10% of asthma patients have severe disease and, in the most severe cases, it can be fatal.
The trial findings, published in The Lancet Respiratory Medicine and presented at the winter meeting of the British Thoracic Society, also showed that tezepelumab significantly improved asthma symptoms, lung function and overall quality of life. During the study, two-thirds of the patients did not have any asthma attacks.
The study’s lead author, Professor David Jackson, a respiratory medicine specialist at King’s College London and clinical lead for asthma services at Guy’s and Royal Brompton Hospitals, said: “As tezepelumab also suppresses allergy-related symptoms and improves chronic rhinosinusitis, the results are particularly exciting for patients with severe asthma who suffer from both upper and lower airway symptoms.”
Responding to the findings, Dr Samantha Walker, director of research and innovation at Asthma + Lung UK, said: “This is an incredibly exciting development for the future of asthma care that could change the lives of people with severe asthma.
“It is important that research into new types of treatments continues, but we know that current funding for lung health research is on life support, despite lung conditions remaining the third highest cause of death in the UK. Studies like this show the positive impact that research can have in providing potentially life-changing treatments for people with asthma and other lung conditions.”
Professor Camilla Hawthorne, President of the Royal College of GPs, said: “Any new interventions that can help patients manage their symptoms more easily and in a safe and effective way will be welcomed.
“The possibility of monthly injections instead of daily pills may also be a more manageable treatment option for some patients.
“As with any emerging research, it is important that the findings are carefully evaluated and considered as clinical guidelines, which GPs use in their daily practice, are developed and updated based on the latest evidence to ensure safety and benefits for patients.”
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