When it comes to understanding asthma, its triggers, risk factors, and treatments, a lot of progress has been made over the last decades. Over 100 genes that increase the susceptibility to asthma have been identified, along with many allergens and risk factors that can trigger asthma symptoms. The current treatment that involves long-term, preventive drugs and rescue drugs (quick reliever medication) works for many people with asthma, but not for everyone. Some may find little relief, while others are refractory to these drugs. For this reason, the research is ongoing to find other better options. Many drugs are under research, but very few will make it on the market. For example, the drug fevipiprant made the lines for many years and it was expected to become the first pill to be marketed for asthma in 20 years. Yet this drug was abandoned in late-stage studies in 2019, as it didn’t show the expected benefits when compared with placebo.
Would you like to know what is the latest treatment for asthma, and which drugs and therapies may be available in the future? Read on to find out the details.
Monoclonal Antibodies
Monoclonal antibodies are gaining more and more popularity. In the last three decades, they switch from research drugs to
Over the last 30 years, monoclonal antibodies have made a significant transformation from research tools to FDA-approved drugs that are used to treat various autoimmune diseases and cancer. There are roughly 30 monoclonal antibodies available in the US and some of them can be prescribed for asthma that does not improve with the first-line therapy (preventive or rescue medication).
As you will see below, there are a few options available. Based on a review/meta-analysis of multiple clinical studies mepolizumab, reslizumab, and benralizumab show proverb benefits for eosinophilic asthma, as they significantly decrease the risk of exacerbations when compared to placebo. Reslizumab and benralizumab also improve lung function, while dupilumab also helps improve lung function in individuals who have frequent flare-ups.
Side effects of monoclonal antibodies include sore throat, headaches, fatigue, weakness, pain, and redness of the injection site. Although rare, severe side effects include life-threatening allergic reactions and heart complications. It is important to monitor your treatment and seek medical treatment if needed. These drugs are in injectable form, and the first doses are given in the hospital. You receive training from a healthcare professional to use these injections at home as you continue the treatment.
- Benralizumab can be indicated for a special subtype of asthma called eosinophilic asthma, which can be hard to treat with standard therapy. The typical treatment plan involves an injection every four weeks for the first three doses, while the rest of the dioceses are given once every 8 weeks.
- Dupilumab is another possible option for eosinophilic asthma that is not well controlled with first line therapy drugs. This injectable drug is given every other week. This drug can also cause an increase the blood levels of certains immune cells eosinophils
- Reslizumab may help treat eosinophilic asthma, and the injection is given once every four weeks.
- Mepolizumab can be used for the treatment of eosinophilic asthma, and the typical treatment plan involves one injection every 4 weeks.
- Omalizumab may be recommended in case of severe asthma associated with year allergies that persist all year around like dust and pet dander. The initial therapy plan involves an injection or two every two to four weeks. Omalizumab has a box warning because of the increased risk of anaphylaxis, and this drug was also linked with other severe side effects like heart attacks and strokes.
Bronchial Thermoplasty
This emerging therapy involves the use and distribution of radiofrequency energy in the airways with the goal of decreasing bronchoconstriction. A flexible bronchoscope is used for this procedure. In 2010, was approved for those age 18 or older with severe persistent asthma that is not well controlled by standard therapy. A review study concluded that this procedure is effective and has an overall good safety profile. However, it is possible for some people to experience a short-term aggravation of the symptoms right after this procedure.
Other Drugs Under Research
Infliximab, Etanercept, and Golimumab target TNF-α, a molecule that causes inflammation. In research studies, these drugs were found to be effective short-term and may help reduce the use of corticosteroids. There are safety concerns with golimumab which include potential risk for cancers and pneumonia.
ASM8, 1018 ISS, and AVE 0675 are a few of the drugs known as oligonucleotide agents. These drugs modulate the immune system and inhibit IgE production. Based on the available research, they help decrease allergic response and may be useful for those with allergic asthma who already receive immunotherapy.
Keep an eye on the research projects on asthma, as we will likely see more therapies available in the future. You can sign up to receive updates from the Asthma Research Center from the Institute for Medicine and Public Health and Asthma and Allergy Foundation of America.
