Monthly injection helps severe asthma patients safely stop or reduce daily steroids, says Lancet study

Monthly injection helps severe asthma patients safely stop or reduce daily steroids, says Lancet study

A monthly injection has helped 90% of severe asthma (chronic inflammatory lung disease) patients reduce daily steroid tablets associated with long-term side effects, says a study published in The Lancet Respiratory Medicine. More than half of the participants, who took the shot, were able to stop their daily steroid tablets entirely without a worsening of symptoms.

The clinical trial followed patients who had been injected with Tezepelumab — a type of antibody which targets parts of the immune system, reducing lung inflammation — every four weeks for a year. According to Prof David Jackson, respiratory medicine expert at King’s College London and lead author of the study, the treatment significantly improved asthma symptoms, lung function and overall quality of life. “During the study, two-thirds of patients stopped having any asthma attacks. These improvements were seen as early as two weeks into treatment and lasted for the duration of the study,” researchers said.

Why this study is a breakthrough
Scientists are trying to identify alternative treatments for managing severe asthma, as long-term daily steroid use can lead to serious health problems. Dr Sundeep Salvi, chair, Chronic Respiratory Diseases, Global Burden of Disease-India, says the new drug showed fewer and milder side effects like nasopharyngitis, headache and bronchitis. “While inhalation therapy with steroids and long-acting bronchodilators continue to form the backbone of asthma treatment for the majority, for the few who need additional oral steroids, Tezepelumab offers hope,” he said.

What the study says
This was a phase 3b, multi-centre study conducted between May 17, 2022 and September 9, 2024. Altogether 382 participants were enrolled while 298 participants (206 of them women [69·1%]) received Tezepelumab. All of them were aged between 18 and 80 with severe, uncontrolled asthma and had been on a maintenance oral corticosteroid (OCS) dose of 5–40 mg per day. They were recruited from 68 clinical centres across 11 countries (Argentina, Belgium, Bulgaria, France, Germany, Latvia, Mexico, Poland, Spain, UK, and USA).

Participants received Tezepelumab (210 mg) subcutaneously once every four weeks for up to 52 weeks. After 52 weeks of open-label Tezepelumab treatment, nearly 90% of patients with OCS-dependent severe, uncontrolled asthma needed a maintenance OCS dose of 5 mg per day or less. More than 50% completely discontinued OCS as their asthma remained under control.

“This is a biologic therapy that targets asthma-related inflammation but without all the side effects of steroids and is capable of allowing the vast majority of patients to wean their steroids down to a low dose with over half able to stop their steroids altogether. 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,” Prof Jackson said.

India accounts for over 40% of global asthma deaths
Asthma is a chronic lung disease that affects over 300 million people worldwide. According to the Global Burden of Disease report, India contributes to an estimated 12.9% of global asthma cases (34.3 million) but a disproportionate 42.3% of all global asthma deaths.

“So, if there are approximately 35–36 million people with asthma, at least 5–10 per cent have severe uncontrolled asthma in the country. Most of them can lead a near normal life with regular use of inhaled medications but some need to use continuous oral steroids that are accompanied by several side effects, affecting the bones, skin, blood sugar and mental health,” Dr Salvi explained.

Drug offers hope but cost is a concern
“The cost of the injection every four weeks is about Rs 1 lakh. For those in genuine need, it might be helpful but affordability is an issue and would put many out of the arc,” Dr Salvi added.