Benralizamab shows significant potential for the treatment of asthma and COPD

Researchers report that an injection of benralizamab administered   during some attacks of asthma and COPD, is significantly more effective than current standard treatment with steroid tablets.

The findings were published on Nov. 27, 2024 in The Lancet Respiratory Medicine.

Lead investigator Professor Mona Bafadhel, Director of the King’s Centre for Lung Health, and the Chair of Respiratory Medicine at King’s College in London. UK said: “This could be a game-changer for people with asthma and COPD. Treatment for asthma and COPD exacerbations have not changed in fifty years despite causing 3.8 million deaths worldwide a year combined.

She continued, “Benralizumab is a safe and effective drug already used to manage severe asthma. We’ve used the drug in a different way — at the point of an exacerbation — to show that it’s more effective than steroid tablets which is the only treatment currently available. The big advance in the ABRA study is the finding that targeted therapy works in asthma and COPD attacks. Instead of giving everyone the same treatment, we found targeting the highest risk patients with very targeted treatment, with the right level of inflammation was much better than guessing what treatment they needed.”

Benralizamab is a monoclonal antibody that reduces inflammation by targeting specific white blood cells called eosinophils.  It is currently used for the treatment of severe asthma.

Between May 13, 2021, and Feb 5, 2024, the investigators screened 287 patients for enrollment in the study. They excluded 129, leaving 158 eligible subjects. They were randomized at the time of acute eosinophilic exacerbation of asthma or COPD.

Eighty-six (54%) of the subjects were female and 72 (46%) were male, with a mean age of 57 years.

The investigators randomized 53 subjects to the PRED (prednisolone tablets plus dummy injection) treatment group, 53 to the BENRA (benralizumab plus dummy tablets) treatment group and 52 to the BENRA plus PRED treatment group.

After 28 days, respiratory symptoms of cough, wheeze, breathlessness and sputum were significantly improved in favor of the of the pooled-BENRA group (P=0.0065).

At 90 days, treatment failures occurred in 39 (74%) of 53 in the PRED group, and 47 (45%) of 105 in the pooled-BENRA group (P=0·0005), a significant difference.

There were no fatal adverse events, Benralizumab was well tolerated.

The authors concluded, “In patients with an eosinophilic exacerbation of asthma or COPD, a single subcutaneous injection of benralizumab, with or without a short course of systemic glucocorticoids (oral prednisolone) reduced treatment failures, prolonged time to first event, and improved respiratory symptoms and disease-specific health quality compared with standard care with oral corticosteroids following an exacerbation.”