A monthly injection could allow people with severe asthma to stop taking daily steroid tablets, a clinical trial has found.
More than 260 million people are thought to have asthma worldwide. While most can control their asthma with inhalers to treat immediate symptoms and preventive ones to reduce inflammation, those with the most severe asthma often take daily doses of oral corticosteroids as well.
But long-term use is associated with serious health conditions, including osteoporosis, diabetes and increased vulnerability to infections.
Now an international clinical trial has found that participants who received injections of tezepelumab every four weeks were able to reduce or even stop taking their steroids entirely with no ill effects.
Tezepelumab, also known as Tezspire and made by AstraZeneca, binds to and blocks a protein associated with airway inflammation.
The National Institute for Health and Care Excellence approved the drug in 2023 as an additional maintenance treatment for patients over 12 whose usual medication does not control their asthma well.
The Wayfinder trial, led by Kings College London, involved just under 300 adults with severe, uncontrolled asthma, who were taking 5mg-40mg of steroid tablets daily.
The patients, from 11 countries including the UK, US, France, Germany, Mexico and Spain, were given tezepelumab every month.
After one year of treatment, more than half of the participants had stopped taking their steroid medication altogether without their asthma flaring up, while nearly 90% had reduced their steroid use to a low dose. A third had stopped taking steroids after six months.
Symptoms of asthma include coughing, wheezing, breathlessness and chest tightness. Up to 10% of asthmatics have severe disease and, in the most extreme cases, it can be fatal.
The trial findings, published in the the Lancet Respiratory Medicine and presented at the British Thoracic Society winter meeting, also showed that tezepelumab significantly improved asthma symptoms, lung function and overall quality of life. During the study, two-thirds of patients did not have any asthma attacks.
The lead author of the study, prof David Jackson, who is a respiratory medicine expert at King’s College London and asthma services clinical lead at Guy’s and Royal Brompton hospitals, said: “As tezepelumab also suppresses allergy-related symptoms and improves chronic rhinosinusitis as well, the results are particularly exciting for patients with severe asthma who suffer with both upper and lower airway symptoms.”
Responding to the findings, Dr Samantha Walker, the director of research and innovation at Asthma + Lung UK, said: “This is an incredibly encouraging development for the future of asthma care that could transform the lives of people with severe asthma.
“It’s vital that research into new types of treatment continues, but we know current funding for lung health research is on life support, despite lung conditions remaining the third biggest cause of death in the UK. Studies like this show the positive impact that research can make on providing potentially life-changing treatment for people with asthma and other lung conditions.”
Prof Kamila Hawthorne, the chair of the Royal College of GPs, said: “Any new interventions that may help patients manage their symptoms more easily and in a safe and effective way would be welcome.
“The prospect of a monthly injection, rather than daily tablets, may also be a more manageable treatment option for some patients.
“As with any emerging research, it’s important the findings are carefully assessed 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 benefit for patients.”
