Biologic therapies can effectively control severe asthma without the need for regular high-dose inhaled steroids, a significant revelation that could transform the lives of millions living with the condition
The multinational SHAMAL study was published in The Lancet in a groundbreaking development.
Benralizumab’s impact on severe Asthma treatment
Led by Professor David Jackson, head of the Severe Asthma Centre at Guy’s and St Thomas’ and Professor of Respiratory Medicine at King’s College London, the study focused on benralizumab, a biologic therapy designed to reduce the number of inflammatory cells known as eosinophils.
These cells are overproduced in the airways of individuals with severe asthma and play a critical role in the development of asthma attacks.
Minimising side effects
The SHAMAL study involved 208 patients across 22 UK, France, Italy, and Germany sites. Patients were randomly assigned to taper their high-dose inhaled steroid by varying amounts over 32 weeks, followed by a 16-week maintenance period.
The results showed that 92% of patients using benralizumab could safely reduce their inhaled steroid dose, with more than 60% able to cease usage completely.
The implications of these findings are profound for the nearly 300 million people worldwide affected by asthma, 3 to 5% of whom suffer from the severe form of the condition. Severe asthma brings daily symptoms of breathlessness, chest tightness, cough, and frequent hospitalizations due to asthma attacks.
One of the most significant advantages of biological therapies like benralizumab is the potential to minimise or eliminate the often serious side effects associated with high-dose inhaled steroids. These side effects include conditions such as osteoporosis, which increases the risk of fractures, as well as diabetes and cataracts.
Professor Jackson expressed enthusiasm about the study’s outcomes, stating, “Biological therapies such as benralizumab have revolutionised severe asthma care in many ways, and the results of this study show for the first time that steroid-related harm can be avoided for the majority of patients using this therapy.”
Availability of Benralizumab
Benralizumab, issued through injections every four to eight weeks, is available in specialist NHS asthma centres. However, further studies similar to SHAMAL are necessary to provide concrete recommendations on the safety and efficacy of reducing or eliminating high-dose steroid use with other biologic therapies.
The SHAMAL study, funded by AstraZeneca, enlisted researchers from esteemed universities, including Queens University Belfast, Université Paris-Saclay, and Trinity College Dublin. As the medical community awaits additional research in this promising field, the potential for transforming severe asthma treatment is on the horizon, offering hope for improved patient outcomes and a reduced burden of side effects.
