Experimental Asthma Drug May Provide Major Relief–But For a Limited Group of Patients

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A promising new drug for treating asthma could not only reduce asthma symptoms but also improve lung function in patients, according to a new study.

The results of the trial involving dupilumab, which is being developed by Regeneron Pharmaceuticals and French drugmaker Sanofi, showed the drug reduced asthma attacks by 87% in patients compared to those taking a placebo.

The findings were presented at the annual meeting of the American Thoracic Society in Philadelphia and published in the New England Journal of Medicine.

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The trial, which was sponsored by the drug’s makers, included 104 adults with moderate to severe asthma. For 12 weeks, 52 of the participants received dupilumab, and the rest of the participants took a placebo. Among the treated group, only three had asthma attacks, which is significantly lower than the 23 episodes reported among the placebo group. The dupilumab users were also less likely to need their short-acting inhalers.

Dr. Sally Wenzel, the lead investigator of the trial told Reuters that the trial provided the most exciting data in asthma in the last 20 years. “We have been treating asthma with sort of Band-Aid therapies that didn’t get at the underlying causes,” she Wenzel. She said the study was written by a medical writer paid by Regeneron, but that she wrote the first draft.

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The drug blocks two proteins, interleukin-4 and interleukin-13, that prior research suggested could play critical roles in triggering asthma and other allergy-related diseases. Because, as Wenzel said, the drug targeted the underlying mechanisms driving the disease, dupilumab could have wide-ranging benefits beyond  just temporarily opening up airways.

However, before the drug can be used by the 25 million Americans who suffer from asthma, more trials need to confirm its effectiveness and safety. As Forbes reports, Regeneron still needs to determine the most effective dosage of dupilumab, and  Sanofi has just begun a two-year long study investigating different doses of the drug compared to a placebo in 600 participants.

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In an accompanying editorial to the study, Dr. Michael Weschler, director of the asthma program at National Jewish Health in Denver, wrote that the dramatic benefit only applied to a subgroup of people with asthma, and that it’s not clear whether the drug would have similar benefit in all asthmatics. In fact, those who showed the most improvement were patients who came off of their inhaled glucocorticoids, which help to reduce inflammation and swelling of airways) or bronchodilaters, which relax the breathing muscles. Weschler wrote that most doctors aren’t likely to recommend stopping these medications, which makes dupilumab “not advantageous in a “real world” situation.”

What’s really needed, he said, is a medication that can supplement inhalers and dilators when these aren’t sufficient to relieve symptoms. Such an advance is desperately needed since the Centers for Disease Control recently found that medical costs of asthma and its complications in the U.S. currently reaches about $56 billion each year, with the average yearly cost of asthma care for a child topping off at about $1,039.

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