According to study results published today in the New England Journal of Medicine, a drug approved to treat psoriasis increased symptoms in people with severe asthma.
Researchers from the National Institute for Health Research (NIHR) Leicester Biomedical Research Center, a collaboration between Leicester’s Hospitals, the University of Leicester, and Loughborough University, investigated whether risankizumab could help people with severe asthma improve their symptoms and reduce their ‘attacks.’
Asthma is an inflammatory lung disease with symptoms ranging from mild to severe. In most situations, asthma may be controlled by avoiding triggers, taking daily medications, and other treatment choices.
However, if you can’t control your asthma with any medicine, it’s likely that your asthma is severe. In addition to other daily treatments, severe asthma may necessitate substantial doses of inhaled corticosteroids or long-term oral corticosteroids.
Asthma symptoms differ from one person to the next. You may have rare asthma episodes, only experience symptoms at particular times of the day, such as when exercising, or experience symptoms all of the time.
We think risankizumab reduces the presence of substances in the airways that are important factors in preventing infections, which probably makes the patients’ symptoms worse. This theory is backed by molecular profiling, which shows reduced levels of these substances in samples taken from patients on the trial.
Chris Brightling
Asthma signs and symptoms include:
- Shortness of breath
- Chest tightness or pain
- Wheezing when exhaling, which is a common sign of asthma in children
- Trouble sleeping caused by shortness of breath, coughing or wheezing
- Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu
Signs that your asthma is probably worsening include:
- Asthma signs and symptoms that are more frequent and bothersome
- Increasing difficulty breathing, as measured with a device used to check how well your lungs are working (peak flow meter)
- The need to use a quick-relief inhaler more often
214 people were included in the worldwide study, which was co-led by researchers from Manchester, Belgium, and Canada. 105 patients were randomly assigned to get a risankizumab injection every four weeks for a 24-week period, whereas 109 patients received a placebo.
Some clinicians disagree on how severe asthma should be defined; severe asthma attacks can be life-threatening. The World Health Organization (WHO) puts severe asthma into three different categories:
- untreated asthma
- difficult-to-treat asthma
- therapy-resistant asthma
It’s unclear why some people develop asthma and others do not, but it’s most likely due to a combination of environmental and genetic variables. Even though severe asthma is tough to cure, it is still feasible to control it. Continue reading to learn about the symptoms of severe asthma, how to recognize an attack, and how to treat your disease.
Greater symptoms, deterioration in breathing tests, increased usage of inhalers, and the requirement for steroid tablets were used to determine the ‘time-to-first’ worsening. The average time to first deterioration for patients who received risankizumab was 40 days, compared to 86 days for those who received a placebo.
Risankizumab was shown to decrease molecules believed to be crucial in infection protection when ‘gene signatures’ from immune cells in airway samples were examined, which could explain the reported poorer asthma control.
Severe asthma is defined as a condition that either does not respond to treatment or is extremely difficult to treat. Therapy-resistant asthma is characterized by a lack of responsiveness to medicines. It’s possible that your asthma has developed resistant to corticosteroids or other asthma treatments.
Professor Chris Brightling, NIHR Senior Investigator at the NIHR Leicester Biomedical Research Centre (BRC) and study lead, said: “It is always disappointing when a potential treatment is shown to be ineffective at treating a disease, more so when it makes symptoms worse.”
“We think risankizumab reduces the presence of substances in the airways that are important factors in preventing infections, which probably makes the patients’ symptoms worse. This theory is backed by molecular profiling, which shows reduced levels of these substances in samples taken from patients on the trial.”
The study, which was sponsored by AbbVie and Boehringer Ingelheim is registered on ClinicalTrials.gov, NCT02443298. It was also partially funded by 3TR-Innovative Medicines Initiative (IMI), a consortium of academic institutions, charities, and industry partners whose goal is to provide fundamental new insights into the molecular pathways and mechanisms of autoimmune, inflammatory, and allergic disease response and non-response to treatment.
