Severe asthma is a debilitating condition and in patients with difficult-to-control asthma this condition worsens over time leading to loss of lung function.
At the moment there is no drug that can alleviate this condition. Current drugs for severe asthma have a temporary effect and reduce the need to go to the emergency room, but they do not improve lung function.
That is why a recent study from researchers at Washington University School of Medicine in St. Louis and other institutions is exciting and promising.
According to two new studies, the eczema drug Dupilumab alleviates the severe symptoms of asthma and improves the ability to breath in patients with severe asthma.
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The first study included 1900 patients with moderate to severe asthma. The patients were 12 years of age or older. They required at least three different inhalers to control their symptoms.
One inhaler contained a corticosteroid that reduces inflammation. The other inhaler contained a long-acting bronchodilator that relaxes airway muscles while third inhaler was an emergency inhaler filled with albuterol – a short-acting bronchodilator that quickly opens up the airway in case of a more severe asthma attack.
Patients taking these inhalers were randomly assigned to receive either dupilumab or a placebo for one year.
Patients who received dupilumab – an injectable anti-inflammatory drug – were also randomly assigned to receive a high dose or a lower dose of the drug.
Neither the patients nor their doctors knew if they were receiving the drug or the placebo.
The rate of asthma exacerbations was almost cut in half (average of one per day) in patients who took the drug compared to the placebo group during the year of the study.
Exacerbations are the sudden worsening of asthma symptoms such as coughing, wheezing, shortness of breath and tightness of chest.
The patients who received the drug also showed lung function improvement.
Regardless of the dose, patients who received the drug improved their lung function by approximately 130-200 millilitres greater than those receiving the placebo.
In general, there were no significant differences between the patients receiving high and low doses of dupilumab.
The findings also reported a reduced rate of emergency room visits and hospitalisations in patients receiving the drug compared to the placebo group.
On average 6.5 percent of placebo patients required an ER visit or hospitalisation while 3.5 percent of patients receiving the drug needed the ER or hospitalisation.
The second study consisted of 200 patients taken from the larger study using the same inhaled medication plus an additional steroid – usually prednisolone to control their more severe symptoms.
Half of the patients receiving dupilumab were able to completely eliminate prednisolone use and 80 percent were able to at least reduce their doses by half.
The findings suggest that dupilumab can be used to wean patients off chronic oral steroids which can cause debilitating long-term side effects such as stunted growth, diabetes, cataracts and osteoporosis.
This study presents a new hope for patients with severe asthma who do not have any other available form of therapy that can help them alleviate their symptoms and help them breathe better.
Source: New England Journal of Medicine
