A jab that soothes itchy skin has been hailed as a breakthrough in the treatment of a devastating lung condition that affects more than a million Britons.
Dupilumab is currently used to treat severe eczema, but a clinical trial has shown that it reduces hospitalizations in some patients with chronic obstructive pulmonary disease (COPD) – an umbrella term for incurable and debilitating lung diseases such as emphysema and chronic bronchitis.
Patients taking the drug were about a third less likely to have severe flare-ups that required hospital treatment. The results, published in the New England Journal of Medicine, also show that it increases lung capacity, reducing shortness of breath and making simple tasks like walking to the store or climbing stairs much easier.
Experts told The Mail on Sunday that dupilumab may be the biggest breakthrough for treating COPD in decades.
“This is a very big development,” said Ian Pavord, a professor of respiratory medicine at the University of Oxford. “The results are really exciting and better than anyone expected. It has long been a desert when it comes to treating COPD.’
Chronic Obstructive Pulmonary Disorder (COPD) is an umbrella term for incurable and debilitating lung diseases such as emphysema and chronic bronchitis
Professor Sir Peter Barnes, from the National Heart and Lung Institute at Imperial College London, says: ‘Most treatments currently used for COPD only relieve symptoms such as shortness of breath, persistent cough and wheezing.
“But this is the first to address the underlying mechanism that causes the disease.”
COPD, which causes inflamed, damaged or blocked lungs, is the fourth leading cause of death in the world. It affects an estimated 1.2 million people in the UK, mostly over 65, and NHS England has said this will rise by a further 40 per cent by the end of the decade due to increased life expectancy.
The condition already accounts for one in eight of all emergency hospital admissions.
The main cause is smoking, responsible for up to 90 percent of cases, but studies suggest that even ex-smokers are still at risk up to 30 years after quitting. However, air pollution and genetics are also involved.
In some types of COPD, the walls of the airways thicken over time and mucus is produced, leaving less room for air to get in and out.
One of the first signs is coughing, but eventually it causes extreme shortness of breath and wheezing. Patients may eventually need to carry an oxygen cylinder with them to breathe.
Dupilumab ‘is a really big development,’ said Ian Pavord, professor of respiratory medicine at the University of Oxford
Current treatment includes medications to widen the airways or exercise programs to strengthen lung capacity, but there have been no new medications for more than a decade.
While the treatment works for some patients, it is much less effective in those with a particularly severe type of COPD, caused by type 2 inflammation – swelling in the airways due to immune system overload, causing sudden shortness of breath in nearly 200,000 patients in the United Kingdom. Type 2 inflammation is also a major trigger in eczema and some people with difficult-to-treat asthma.
Dupilumab was originally developed to address these conditions by blocking the process that leads to severe inflammation. However, the latest results show that the drug can also change the lives of many COPD patients, with inflammation being a trigger.
Doctors tested 939 patients and put half on biweekly injections of dupilumab and the rest on placebo before following them for at least a year.
The results showed that there were a third fewer flare-ups in those taking the drug. Some patients started to see an improvement within just two weeks.
Most patients more than doubled the amount of air they could blow out of their lungs in one second — the standard test for the condition.
While the drug, which costs around £600 per shot, will only work for those in whom type 2 inflammation is a trigger, doctors say it’s still the biggest advance in years.
Professor Pavord added: ‘There is another large dupilumab trial in COPD that will be reported next year, and there are at least six other similar drugs in the pipeline that are expected to be just as good.’
He says the drug could be recommended within two years by the NHS watchdog, the National Institute for Health and Care Excellence – and available to patients.