Dr Michelle Dickinson: nanotechnologist on the new 'game-changing' asthma treatment

Asthma and chronic obstructive pulmonary disease (COPD) are significant health challenges, with asthma affecting around 600,000 New Zealanders  - with one in seven children and one in eight adults living with the condition. 

Tragically, asthma contributes to an average of 60 deaths per year in New Zealand, and Māori and Pasifika communities are disproportionately affected. 

New research out this week in the journal The Lancet could offer fresh hope. 

For the first time in 50 years, a new drug, benralizumab, has shown remarkable potential for treating severe asthma attacks. Clinical trials, led by researchers at King’s College London, revealed that the drug outperformed conventional steroid tablets in treating life-threatening breathing difficulties caused by a severe form of asthma known as eosinophilic asthma. 

This type of asthma, which involves white blood cells called eosinophils, leads to inflammation that can cause the airways to swell and close. It’s responsible for nearly half of all emergency asthma flare-ups and contributes to severe exacerbations of COPD as well. 

The trials demonstrated that patients who received an injection of benralizumab during an attack were less likely to experience symptoms like wheezing and breathlessness even four weeks later, compared to those treated with steroids. Importantly, these patients also reported a significant improvement in their overall quality of life, marking a shift in how we could manage these conditions moving forward. 

Asthma and COPD place a heavy burden on New Zealand’s healthcare system, with thousands of hospital admissions every year. The reliance on steroid tablets during flare-ups has long been the standard treatment. While steroids can reduce inflammation, they don’t work for everyone, and repeated use carries risks, including diabetes and osteoporosis. 

Benralizumab offers a different approach by specifically targeting eosinophils, providing a more precise and effective treatment option. This treatment could improve outcomes for over a billion people globally. 

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Episode Transcript

Speaker 1 (00:06):
You're listening to the Sunday Session podcast with Francesca Rudgin
from News Talks EDB.

Speaker 2 (00:13):
And doctor Michelle Dickinson joins me now with her science
study of the week. And we've got a fascinating study
which Michelle indicates sort of a game changer for how
we may deal with esthma.

Speaker 3 (00:26):
A total game changer. And I didn't realize that we
haven't really innovated in asthma treatment for fifty years, and
so this is the first time that we've looked at
it and gone, how do we do something totally different?
And anybody who has asthma, and that's one and seven
children in New Zealand and one in eight adult the
other way around, one in Cloe, one in seven Ish ye, yeah,
one in eight adults. And it results obviously in sixty

(00:47):
deaths a year, but so many hospitalizations and just the
panic and the stress of asmith. If you're living with it,
you know it's awful. We have a few solutions. You
might have an inhaler at home that's designed to help
sort of help your sort of airways to sort of
expand and get some air in. If you have an
asthma attack, you typically are given us steroid treatment, so

(01:07):
a tablet steroid that tries to sort of open things
up for you, but we haven't actually treated the cause
they're all post treatment of what's happening to you. And
so this new research which is actually in the Lancer,
it's open source. You can read it if you want.
It's a bit meating. It's based on this new clinical
trial and it's amazing and it's using this new drug.

(01:28):
This new drug has a horribly, horribly hard to pronounce name.
It's called benralisubmab. It's also awful to spell. So look
for new drug and asthma if you're googling this, and
it is. It has shown in its clinical trials to
massively outperform the conventional steroid tablets that we do. And
it's only in a certain type of asthma, but actually

(01:50):
most asthma attacks are based on this and it's called
eosynophilic asthma. And basically, in that type of asthmatic attack,
you have these inflammatory white blood cells and during the
asthma attack, they just come into your airways and they
cause your airways to swell, and that's what causes your
airways to close because it's an inflammatory response. Your white

(02:12):
blood cells are trying to deal with this response by
putting all these white blood cells in there, but actually
they're teching more problems. And so instead of giving a
steroid treatment just tries to relax your airways, this drug
just finds these cells and zeps them and they're gone Burgers.
That's it. It literally goes through what's called cellopeptosis, which

(02:33):
is killing the cells. So it kills these white blood
cells almost immediately.

Speaker 2 (02:36):
And obviously if we don't need them, and we.

Speaker 3 (02:38):
Don't need them as much as you need your airways,
right I said, this is not for everybody, but if
you have an attack, the thing that's killing you is
yourself these white blood cells, and it just goes We're
just gonna there's too many of them. We're just gonna
get rid of them right now. Your body can remake
them later if it needs to, but right now, we
just need to get over the fact that there are
too many of them. And that's it. And the nice

(02:58):
thing about this, so it's one injection that you would
have during an attack. Was in the clinical trials, what
they're saying is, can we just give this one injection
as a sort of baseline once a year, come in,
get your esthma jut and then you're you're fine. And
they showed that they only measured up to four weeks later,
but the effect lasted four weeks. These people didn't have
any flare ups. They said that quality life was amazing.

(03:20):
They could feel, they could breathe easy, they were less stressed.

Speaker 2 (03:23):
So then they're not taking their preventative pather or.

Speaker 3 (03:25):
Having tea, living a normal life.

Speaker 2 (03:29):
So how do we know if we've got the esthma
that would respond to this.

Speaker 3 (03:33):
I don't know the answer that I assume your your
clinician or your doctor would know because of the type
of symptoms that you would have. Literally though it's it's
totally game changing, and it's still in clinical trials, but
they were like, this will revolutionize people's lives who live
with us.

Speaker 2 (03:49):
So couldn't be beneficial for other respiratory issues that we
have because we have a lot with our young people,
don't we.

Speaker 3 (03:55):
Yeah, So they've said that they've only seen positive effects
in both esthma and what's called chronic obstructive Pomri disease
so COPD. Yeah, that's the only thing that they've seen
in which they know of cause by this type of
white cell. So eosinophils are the type of white blood
cell that are specific to these types of diseases. They've
only seen it do that. And because it's a very

(04:17):
targeted treatment, it literally only goes to these types of cells,
probably not unless other things are caused by these very
specific type of blood cells. But huge trials happening, huge results,
and I think an actual real and it says a
game changer, and I think this really is if we
can get it through.

Speaker 2 (04:35):
Yeah, that's a question. But I suppose because it is
something which affils so many people globally, they will be
a push. Surely would they be.

Speaker 3 (04:44):
Globally apparently affected by it. And I think when drug
companies see that sort of number, and places like the
World Health Organization to that, and when it's preventative in
treating the problem versus treating the symptoms, which is what
we do now.

Speaker 2 (04:58):
So do you know, I'm sorry, I'm putting it on
the spot here a little, But generally when something like
this is going through a trial, how long can that take?
I mean it can take years, it can take dick.

Speaker 3 (05:09):
It's sometimes so it's all about FDA approval. But actually
this is a phase two clinical so this is pretty
far along. I've also seen a couple of the manufacturers
of these types of drugs in the US are already
starting to advertise it as a come and join our trial,
So I think it's pretty far along. Like I think,
within that range and where we are on the trials,
maybe in the next twelve months. Now we always know

(05:29):
New Zealanders behind on adopting these things, but I think
at least in the US people could start maybe being
prescribed within twelve months. The data is beautiful. The clinical
trials have been amazing. They're big studies. Now I think
we're sort of on that cusp and then we just
sit and wait and see what happens in New Zealand
and whether we adopt it.

Speaker 2 (05:46):
Great news. Thank you so much for bringing it to
our tension. That was doctor Michelle Dickinson.

Speaker 1 (05:51):
For more from the Sunday session with Francesca Rudgin, listen
live to News Talks it'd be from nine am Sunday,
or follow the podcast on iHeartRadio.