Asthma and COPD injection outperforms steroids in first major advance in 50 years

For the first time in half a century, researchers have found a treatment that works better than steroids for acute asthma and COPD attacks — and the results were dramatic enough that doctors are calling it a potential turning point for hundreds of millions of patients worldwide.

At a glance

• Benralizumab injection: A single high-dose injection of the monoclonal antibody outperformed steroid tablets at both 28 and 90 days, with four times fewer treatment failures in the benralizumab group by the three-month mark.
• COPD and asthma flare-ups: The trial targeted eosinophilic exacerbations — the biological subtype behind roughly 50% of asthma attacks and 30% of COPD attacks — identified with a rapid blood test in the emergency department.
• Treatment failure rate: Patients receiving benralizumab needed 30% fewer follow-up medical interventions compared with those on standard steroid care, and reported a better quality of life throughout the study period.

Why this matters now

Asthma and COPD together cause an estimated 3.8 million deaths worldwide every year. COPD alone is the third leading cause of death globally. Yet the standard of care for acute attacks — a short course of oral corticosteroids — has not meaningfully changed since the 1970s.

Steroids carry serious long-term risks, including elevated chances of developing diabetes and osteoporosis. A treatment that achieves better outcomes without those side effects would represent a genuine shift in how emergency respiratory care works — not just in well-resourced hospitals, but potentially in GP offices and even at home.

How the trial worked

The study, published in Lancet Respiratory Medicine in November 2024 C.E., enrolled 158 patients who sought emergency care for an asthma or COPD attack at Oxford University Hospitals NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust. The trial was led by King’s College London.

Patients received a quick blood test to identify whether their attack was eosinophilic. Those who were were then randomly assigned to one of three groups: benralizumab injection plus a placebo tablet, standard steroid tablets plus a placebo injection, or both the injection and steroids together.

The benralizumab groups outperformed steroids alone on every key measure — symptom scores at 28 days, treatment failure rates at 90 days, and patient-reported quality of life. The drug works by targeting eosinophils, specific white blood cells that drive lung inflammation during these kinds of attacks.

Lead investigator Professor Mona Bafadhel of King’s College London noted that benralizumab is already approved and in use at lower doses as a maintenance therapy for severe asthma. The trial showed that deploying it at a higher single dose during an attack — rather than between them — could be highly effective.

A drug already in use, deployed in a new way

One of the more striking aspects of this finding is that benralizumab isn’t new. It’s a known, approved monoclonal antibody with an established safety profile. What changed here is the timing and dosage strategy.

That matters enormously for how quickly this could move from research to real-world use. First author Dr. Sanjay Ramakrishnan, clinical senior lecturer at the University of Western Australia, put it plainly: “COPD is the third leading cause of death worldwide but treatment for the condition is stuck in the 20th century. We need to provide these patients with life-saving options before their time runs out.”

AstraZeneca provided the drug and funded the research, though researchers confirmed the company had no involvement in trial design, analysis, or interpretation.

This kind of progress connects to a broader shift in medicine — moving from blunt, systemic treatments toward targeted interventions that address specific biological mechanisms. The same logic is driving advances in Alzheimer’s prevention research and contributing to the long-term trends behind falling cancer death rates in the U.K.

What still needs to happen

The trial was relatively small at 158 participants, and larger confirmatory studies will be needed before benralizumab becomes a standard emergency treatment for COPD and asthma attacks. Regulatory approval pathways and questions around equitable access — particularly in lower-income countries where COPD mortality is highest — remain unresolved.

Dr. Samantha Walker, director of research and innovation at Asthma and Lung UK, welcomed the findings while pointing to a harder truth: the 50-year gap itself is a sign of how severely underfunded lung health research has been. The advance is real. The system that allowed such a long drought is worth examining.

Still, for the millions of people who have sat in emergency rooms wheezing through a COPD or asthma attack, a more effective, faster-acting treatment with fewer side effects — potentially administered at home or a GP’s office — would be a meaningful change in what their lives look like.

You can explore more stories like this in the Good News for Humankind archive on health.

Read more

For more on this story, see: The Guardian

For more from Good News for Humankind, see:

• Alzheimer’s risk cut in half by drug in landmark prevention trial
• U.K. cancer death rates down to their lowest level on record
• The Good News for Humankind archive on health

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