Monthly Injections May Replace Daily Steroid Medications for Severe Asthma

Severe, poorly controlled asthma might increasingly be managed with monthly injections

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Individuals suffering from severe asthma often depend on daily steroid medications, raising their likelihood of diabetes, infections, and bone issues. A new study indicates that monthly antibody injections could serve as a safer alternative.

When asthma is unmanageable with an inhaler, steroid drugs are commonly used, effectively decreasing airway inflammation and alleviating symptoms alongside the risk of asthma attacks. However, these medications can lead to serious side effects. “We aim to minimize the usage of oral steroids,” says Fan Chun from Imperial College London, who was not part of the research.

Previous studies demonstrated that tezepelumab, a monthly antibody injection, reduces the symptoms of severe asthma more effectively than a placebo. This has led to its approval in several countries, including the UK and the US, over recent years. However, it remained uncertain whether this treatment could lessen or eliminate the reliance on steroid drugs.

To investigate this, David Jackson and his colleagues at Guy’s and St Thomas’ Hospital in London recruited 298 individuals aged 18 to 80 with severe asthma from 11 countries. Participants were already using daily inhalers and steroids and were asked to take tezepelumab for one year. Chung noted that a control group wasn’t necessary since prior trials established that the injection had a significant effect compared to a placebo.

Researchers observed that, under medical supervision, participants’ oral steroid doses gradually decreased throughout the study.

By the end of the year, around half of the participants no longer required steroid medication, while 40% were able to reduce their doses enough to “minimize side effects,” according to Chung. “This outcome is highly successful,” he stated. “The trial confirms that tezepelumab is an effective treatment for patients with severe asthma, decreasing the need for daily medications.”

Side effects, such as worsening asthma symptoms, were reported by 9% of participants. However, it is unclear if these were due to the injection or existed beforehand, Chong explained. Nonetheless, he considers the rate acceptable given the advantages of reducing steroid use.

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Source: www.newscientist.com

Daily Pills May Offer a Substitute for Weight Loss Injections

Pills may provide a more convenient method for taking weight-loss medications

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An oral pill could soon serve as an alternative to Wegovy and Ozempic injections after research demonstrated that it significantly reduces weight and enhances blood sugar levels in individuals with obesity and type 2 diabetes.

Created by the pharmaceutical giant Eli Lilly, Orforglipron mimics the action of semaglutide, the key ingredient found in Wigovy and Ozempic, by imitating a hormone known as GLP-1.

In a previous trial, researchers discovered that individuals who were obese but did not have type 2 diabetes could lose an average of approximately 11 percent of their body weight over 72 weeks while using Orforglipron. Although this is less than the 15% typically observed with similar treatments, many find the convenience of taking a pill more appealing. With semaglutide injections, the preference for oral medication becomes clear, as noted by Deborah Horn from the University of Texas.

To assess its effectiveness for those with obesity and type 2 diabetes, Horn and her colleagues enlisted over 1,600 individuals from ten countries, including India, Australia, China, Germany, Brazil, and the United States.

Approximately 900 participants were assigned to receive varying daily doses of orforglipron—low, medium, or high—while the remainder received placebo pills alongside lifestyle guidance.

After 72 weeks, individuals in the high-dose group lost nearly 10 percent on average, with 67 percent of that group achieving over 5 percent weight loss. The middle and low-dose groups recorded around 7 percent and 5 percent reductions, respectively, while the placebo group had less than a 3 percent decrease.

This study reaffirms that Orforglipron results in less weight loss compared to injectable GLP-1 medications; however, it may still enhance health and quality of life. Stefan Trapp from University College London, who did not participate in the study, remarked, “Even a modest 5% weight loss generally leads to clear benefits, such as increased exercise capacity, lifestyle changes, and reduced risk of other illnesses.”

Moreover, participants receiving high doses experienced an average drop of nearly 2 percent in blood sugar levels, with approximately 75 percent reaching levels typically aimed for diabetics, Horn shared. Conversely, those on lower doses saw a mere 0.1% reduction, while the placebo group exhibited no significant change.

Roughly 10% of the individuals taking high and medium doses had to discontinue use due to side effects like nausea, vomiting, and diarrhea—nearly double the occurrence seen in the low and placebo groups. Nonetheless, most participants deemed the side effects manageable, according to Horn. “The side effects were standard for other GLP-1 injectable medications,” she explained.

Horn mentioned that Eli Lilly anticipates the FDA will approve the drug for obesity and type 2 diabetes by early next year. As a physician, she hopes for approval of all three doses to provide patients with options to optimize their health while minimizing side effects.

Orforglipron does not necessitate refrigeration or syringes, which may lower manufacturing, storage, and distribution costs compared to injectable GLP-1 drugs. This, along with the elimination of injection-related discomfort, could enhance access to GLP-1 weight-loss drugs, which are currently costly and hard to obtain in many low- and middle-income nations, Trapp noted.

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Source: www.newscientist.com

Inhaled Insulin Available at No Cost for Children with Type 1 Diabetes Using Injections

Afrezza: Inhaled Insulin

MannKind Corporation

Inhaled insulin, specifically Afrezza, effectively manages blood glucose levels in children with type 1 diabetes, similar to injected insulin. Afrezza is already approved for use in adults with both type 1 and type 2 diabetes in the US, and the manufacturer is looking to gain approval for pediatric use.

Type 1 diabetes occurs when the body cannot produce insulin, the hormone responsible for regulating blood sugar. Individuals with this condition typically require daily insulin injections. However, managing blood sugar levels can be challenging, particularly after meals or following exercise.

Dr. Michael Haller from the University of Florida, who has worked on Afrezza’s advisory board, explored the potential of inhaled insulin to enhance glycemic control in adults. Preliminary findings suggest it could be more effective for children than traditional injections. A study was conducted with 230 participants aged 4 to 17, including both type 1 and type 2 diabetes patients requiring insulin.

All participants were on a basal insulin regimen, administered once or twice daily to maintain baseline levels. Additional rapid-acting insulin was generally required before meals. In the 26-week trial, some children utilized Afrezza as their rapid-acting insulin, while others continued with injectable insulin.

Results indicated that both insulin types achieved comparable blood glucose control. These findings were presented at the American Diabetes Association Conference in Chicago in June. More details can be found here.

“This suggests that Afrezza could be a preferable option for patients due to the delivery method, particularly for those with needle anxiety,” Dr. Haller states. “More importantly, it provides patients with additional strategies for managing a complex condition.”

While some users experienced coughing with the inhaled version, it resolved once they acclimated. However, Afrezza is not recommended for individuals with chronic lung issues like asthma.

Dr. Kathryn Sumpter from the University of Tennessee Health Science Center suggests that inhaled insulin may benefit certain diabetes patients, particularly children who often forget to take their medication before meals. Nonetheless, she believes that many would prefer the injected form, especially for younger children needing precise dosing.

MannKind Corporation intends to seek regulatory approval for pediatric usage of Afrezza in the United States, as noted by Dr. Haller.

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Source: www.newscientist.com