A groundbreaking study published in The Lancet Respiratory Medicine has revealed that a monthly injection can help severe asthma patients safely reduce or completely stop their daily steroid medications. The research shows that 90% of participants were able to significantly cut down their steroid intake, with more than half stopping altogether without any worsening of their asthma symptoms.
Clinical Trial Details and Remarkable Results
The clinical trial followed 382 participants who received injections of the drug Tezepelumab every four weeks for a full year. Tezepelumab is a specialized antibody that targets specific parts of the immune system to reduce lung inflammation. Among the 298 participants who completed the Tezepelumab treatment, 206 were women, representing 69.1% of the study group.
All participants were aged between 18 and 80 years and had been diagnosed with severe, uncontrolled asthma. They had been maintaining daily oral corticosteroid doses ranging from 5-40 mg before joining the study. The research was conducted across 68 clinical centers in 11 countries including Argentina, Belgium, Bulgaria, France, Germany, Latvia, Mexico, Poland, Spain, UK, and USA between May 2022 and September 2024.
After 52 weeks of treatment, nearly 90% of patients required a maintenance steroid dose of 5 mg per day or less, while more than 50% were able to completely discontinue their steroid medications while keeping their asthma under control.
Expert Insights on Treatment Benefits
According to Professor David Jackson, respiratory medicine expert at King's College London and the study's lead author, the treatment demonstrated significant improvements across multiple parameters. "The treatment significantly improved asthma symptoms, lung function and overall quality of life," Professor Jackson stated.
The benefits appeared rapidly, with researchers noting that two-thirds of patients stopped having asthma attacks entirely, and these improvements were visible as early as two weeks into the treatment regimen. The positive effects lasted throughout the entire duration of the study.
Professor Jackson emphasized the broader implications: "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."
Significance for Asthma Treatment in India
The findings are particularly relevant for India, which faces a disproportionate burden of asthma mortality. According to the Global Burden of Disease report, India accounts for 12.9% of global asthma cases (34.3 million) but contributes to 42.3% of all global asthma deaths worldwide.
Dr. Sundeep Salvi, chair of Chronic Respiratory Diseases for Global Burden of Disease-India, explained the local context: "If there are approximately 35-36 million people with asthma, at least 5-10 percent have severe uncontrolled asthma in the country. Most 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 noted that while inhalation therapy with steroids and long-acting bronchodilators remains the primary treatment for most asthma patients, Tezepelumab offers new hope for those requiring additional oral steroids. The drug showed fewer and milder side effects, primarily nasopharyngitis, headache, and bronchitis.
Cost Concerns and Accessibility
Despite the promising results, affordability remains a significant concern for Indian patients. Dr. Salvi highlighted that the cost of each injection is approximately Rs 1 lakh, required every four weeks. "For those in genuine need, it might be helpful but affordability is an issue and would put many out of the arc," he added.
The study represents a major advancement in severe asthma management, particularly for patients who have struggled with the serious health complications associated with long-term steroid use. As Professor Jackson pointed out, the drug's additional benefits in suppressing allergy-related symptoms and improving chronic rhinosinusitis make it especially valuable for patients suffering from both upper and lower airway symptoms.
