Doctors hail first breakthrough in asthma and COPD treatment in 50 years

For the first time in half a century, doctors have a new tool for treating serious asthma and COPD attacks — and early results suggest it works far better than anything available today. A clinical trial found that a single injection of the monoclonal antibody benralizumab outperforms standard steroid tablets, cutting the need for further treatment by 30% and improving quality of life for patients over 90 days.

At a glance

• Benralizumab injection: A single high-dose injection at the point of an asthma or COPD attack proved more effective than the five-day steroid tablet regimen that has been the only standard treatment for decades.
• Eosinophilic exacerbations: These inflammation-driven attacks — caused by elevated white blood cells in the lungs — account for roughly 50% of asthma attacks and 30% of COPD episodes, making a large share of patients eligible for this approach.
• Treatment failure rate: After 90 days, patients who received the injection had four times fewer treatment failures compared with those on steroids alone, with fewer GP and hospital visits required.

Why this matters for millions of people

Asthma and COPD together cause an estimated 3.8 million deaths worldwide each year. COPD alone is the third leading cause of death globally. Despite that toll, the core emergency treatment — a short course of oral corticosteroids — has remained essentially unchanged since the 1970s.

Steroids work, but they carry serious risks. Long-term or repeated use raises the likelihood of diabetes, osteoporosis, and other complications. For patients who experience frequent flare-ups, the cumulative harm adds up quickly. A treatment that reduces the need for steroids altogether is not just a clinical improvement — it’s a meaningful quality-of-life shift.

The trial, led by Professor Mona Bafadhel of King’s College London and carried out at Oxford University Hospitals NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust, enrolled 158 people who arrived at emergency departments during acute attacks. Patients received a rapid blood test to confirm the attack was eosinophilic, then were randomly assigned to receive the injection alone, steroids alone, or both.

The benralizumab groups showed measurably better respiratory symptoms — including coughing, wheezing, breathlessness, and sputum — at the 28-day mark, whether or not they also received steroids. By 90 days, the gap had widened significantly.

How benralizumab works

Benralizumab is already approved as a low-dose maintenance therapy for severe asthma. It works by targeting eosinophils, a type of white blood cell that drives inflammation in the lungs. What the trial demonstrated is that a higher single dose, delivered at the moment of a flare-up, can rapidly suppress that inflammation more effectively than steroids.

The results were published in The Lancet Respiratory Medicine in November 2024 C.E. The drug was supplied by AstraZeneca, which also funded the research — though the company had no role in trial design, analysis, or interpretation.

First author Dr. Sanjay Ramakrishnan, a clinical senior lecturer at the University of Western Australia, said the findings represent “massive promise” for patients whose condition has been managed with tools developed in the previous century. Researchers also noted that benralizumab could potentially be administered at home or in a GP’s office, reducing emergency department visits — a significant advantage for patients and health systems alike.

What still needs to happen

The trial was relatively small at 158 participants, and larger studies will be needed before benralizumab becomes a standard emergency treatment. Regulatory approval for this specific use — a high-dose injection during an acute attack — would also be required in each country before it could reach patients at scale.

The reaction from the lung health community has been cautiously enthusiastic but pointed. Dr. Samantha Walker, director of research and innovation at Asthma + Lung UK, welcomed the findings while noting that the 50-year gap in treatment progress reflects chronic underfunding of lung health research — a structural problem this single trial cannot fix on its own.

Still, for the millions of people who manage serious asthma or COPD and dread the next attack, the prospect of a safer, more effective emergency treatment is genuinely significant. The science is moving. The 50-year wait may finally be ending.

Read more

For more on this story, see: The Guardian

For more from Good News for Humankind, see:

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• The Good News for Humankind archive on global health

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