Israeli Study Confirms Effectiveness of Drug for Severe Asthma

Good news for people suffering from one of the most severe forms of bronchial asthma. A two-year study of the biological drug Nucala (mepolizumab), conducted at one of the Israeli medical centers, demonstrated that its use significantly improves the condition of patients with severe eosinophilic asthma that is not controlled by other medications. Nearly 80% of study participants experienced a reduction in the frequency of asthma attacks with the new drug.

It is noted that the manufacturer of Nucala, the British pharmaceutical company GlaxoSmithKline, did not participate in funding the study, the results of which were published in the medical journal Journal of Asthma and presented at a recent meeting of the Israeli Pulmonology Society.

According to the World Health Organization, approximately a quarter of a billion people worldwide suffer from bronchial asthma, and their numbers are constantly growing. This chronic inflammatory disease of the airways is characterized by bronchospasm. The disease is accompanied by symptoms of wheezing, coughing with thick mucus, episodes of suffocation that primarily occur at night, a feeling of tightness in the chest, and pronounced shortness of breath even with minimal physical exertion.

Statistics show that nearly one in three people suffering from bronchial asthma has the disease in a severe form, which significantly reduces quality of life and increases the risk of serious lung function impairment due to structural remodeling of the bronchial walls caused by chronic inflammation.

One of the most common phenotypes of severe asthma is eosinophilic asthma, which occurs in at least half of patients. One of the key reasons for the severe uncontrolled course of the disease is the increased concentration of eosinophils in the mucus—one type of leukocyte, immune system cells that protect the body from parasites and are involved in the development of allergic reactions. People with this form of asthma seek medical help more frequently than others; they also belong to a high-risk group for mortality.

The main goal of treatment for severe eosinophilic asthma is to achieve symptom control and prevent exacerbations. Approaches to this have changed in recent years as scientists discover new biological mechanisms of disease progression. Currently, targeted therapy with biological drugs, one of which is Nucala, is recognized as the most effective.

Its action targets interleukin-5 (IL-5)—a polypeptide that plays a key role in regulating the functions of eosinophils involved in the pathogenesis of bronchial asthma. It controls their maturation process in the bone marrow, differentiation, recruitment, transportation to the site of inflammation, activation, and survival.

The drug Nucala is a monoclonal antibody that selectively blocks the activity of IL-5. It reduces the eosinophil count, which decreases airway inflammation and prevents disease progression. It became the first biological drug against interleukin-5 approved by the U.S. Food and Drug Administration for home use in patients with severe eosinophilic asthma.

As the study results showed, only 13% of patients treated with the new drug had the same frequency of asthma attacks, while 85% experienced a significant reduction. Nearly 70% of subjects completely discontinued inhaled glucocorticoids or halved their dosage after experimental treatment. The number of exacerbations requiring hospitalization also decreased by about the same amount. Over 80% of those suffering from eosinophilic airway inflammation reported significant improvement in well-being and overall quality of life compared to those receiving standard therapy and placebo.

"The study results are impressive and provide great hope, and it is especially pleasing that they were obtained right here in Israel," says lead author, Israeli professor Mordechai Kramer. "Severe forms of asthma, including eosinophilic, pose a significant threat to life. And I am glad that new treatment options are emerging that can alleviate the condition of such patients and reduce risks.

We have demonstrated that therapy with Nucala is even more effective than previous studies indicated. Moreover, importantly, our team assessed the impact of treatment on patients' quality of everyday life, which allowed us to evaluate its effectiveness in real, rather than laboratory conditions."

"I have suffered from bronchial asthma for many years," says one study participant, 41-year-old lawyer Mali Taibe, a resident of Givat Shmuel. "I was prescribed steroid medications, which made me gain a lot of weight and worsened my vision. Over time, it became difficult for me to perform the simplest daily tasks; washing a plate after lunch felt like running a half marathon. Due to my condition, I constantly needed help from my loved ones.

The disease also negatively affected my work: due to severe shortness of breath, it was difficult for me to communicate with clients over the phone. At that time, my lungs were functioning at just under 40%. Life became torture. But after the very first injection of Nucala, my condition improved significantly; I felt like I was reborn. Now, after the course of treatment, I can run, work out at the gym, and perform my job without any problems."

The authors of the study noted that a number of new pharmacological agents for bronchial asthma, including the biological drugs Dupixent and Fasenra, are planned to be included in the national drug basket in Israel next year.