First asthma pill for 20 years has completed trials and has fewer side effects than steroids

The first asthma pill for 20 years which could actually prevent attacks has completed trials and has fewer side effects than steroids, according to a new study.

Researchers at the University of Leicester created the pill which works by treating muscles in the airways.

The team helped by colleagues from Vancouver, Canada investigated ‘Fevipiprant’ and found that it can repair the muscle in asthma sufferer airways.

This, according to a phase II trial, can greatly assist the breathing of asthma patients when they experience shortness of breath.

In the study, researchers combined their findings from a clinical trial, laboratory experiments and computer-based models.

Fevipiprant was shown to reduce the amount of a type of muscle, known as smooth muscle, in the airway lining – which is the strongest predictor of asthma.

Professor Chris Brightling, a consultant respiratory physician at Leicester’s Hospitals, said the trials were a success for patients.

He said: “Our research shows for the first time that Fevipiprant not only reduces inflammation in the airways, but also reduces the amount of muscle in the lining of the airway.

“This is likely to explain some of the effects seen in the symptoms and breathing tests following treatment.”

The pill, ‘an oral, selective prostaglandin D2 receptor antagonist’, has now been shown to stop attacks before they take place.

Professor Brightling said: “Our findings suggest that Fevipiprant could have positive long-term effects through remodelling, as well as improve symptoms and reduce attacks.

“The latest research gives us a better understanding of the mechanisms behind the efficacy of the drug and how changes in one part of the airway wall can impact on others.

“From previous trials conducted we found that Fevipiprant led to improvements in symptoms, breathing tests, inflammation and also helped to repair the lining of patients’ airways.”

Current treatment for severe asthma is a procedure called thermoplasty, which uses thermal energy to decrease smooth muscle in the airways.

Many avoid the treatment, which is not a cure and requires sedation in hospital – and instead opt for high does of oral steroids.

Fevipiprant’s potential to replace steroids could lead to a reduction in the possible side-effects associated with oral steroids.

These include weight gain, osteoporosis, diabetes and high blood pressure.

The more patients take steroids to manage their asthma symptoms, the less effective the same doses become in future.

Dr Ruth Saunders, who led the experimental laboratory-based work in the study, said a combination of factors led to the success.

She said: “One novel aspect of our study was the way we combined information from a clinical trial, laboratory experiments and computer-based models to give insights that would not have been possible with any of these approaches alone.”

Dr Himanshu Kaul, of the University of British Columbia, said: “Our computer model represents a milestone towards patient-specific models in respiratory medicine that has the potential to help design new drugs and optimise existing therapies.

“Eventually, it could play a role in furthering precision medicine by helping predict the optimal intervention tailored to individual patients given their genomic information.”

Dr Linda Armstrong, of the Head Respiratory Development Unit at Novartis pharmaceutical company called the trial “encouraging”.

She said: “Fevipiprant has the potential to significantly improve the treatment of asthma patients who do not achieve disease control on optimised inhaled therapy.

“We look forward to the completion of our currently ongoing phase 3 clinical development program and hope to make this once daily oral treatment with fevipiprant available to patients as quickly as possible.”

Asthma affects over 300 million people worldwide and there half-a-million people with moderate to severe forms in the UK.

There is currently no routinely-available drug on the NHS that targets smooth muscle mass to reduce asthma symptoms.

The study was supported by experts at the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre.

Their findings were published in the journal Science Translational Medicine.


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