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Dupilumab: ‘Wonder drug’ for severe asthma approved for use by NHS in England

A drug that is being hailed as a major breakthrough in the treatment for uncontrolled asthma has been approved for use by the NHS in England.

Dupilumab has been recommended by the National Institute for Health and Care Excellence (NICE) for some patients whose asthma does not respond to conventional treatments.

The drug is a monoclonal antibody – from a family of drugs that is being also being used to treat COVID – which is also prescribed for severe eczema and rhinosinusitis. It was approved for use in Scotland in April.

But it is known to cause side effects, including inflammation, headaches and more rarely severe allergic reactions.

Only patients who have severe asthma with type 2 inflammation (a defined pattern of immune response), who meet an inflammation threshold, have had at least four severe asthma attacks in the last year and are ineligible for other biological treatments will be considered for prescription.

Patients’ group Asthma UK and the British Lung Foundation Partnership, which merged to become a new single charity in 2020, welcomed the news, saying it would transform the lives of some people who suffer with the condition.

Some 200,000 people in the UK suffer regular asthma attacks and have to undertake emergency trips to hospital.

Dupilumab has been shown in clinical trials to reduce the frequency with which asthma attacks occur and the amount emergency steroid tablets have to be used by almost half when combined with standard inhalers.

Nicki Ridgway, 38, from Oxford, who was one of just a few people in England given access to dupilumab before the NICE decision, told Asthma UK earlier this year: “This new drug is a wonder drug that has totally turned my life around.

“My asthma was so bad that I spent my late twenties and early thirties being blue-lighted to hospital regularly with life-threatening asthma attacks, rigged up to machines to help me breathe and not knowing if I was going to see my 35th birthday.

“Since I have been on dupilumab, I feel like a new woman.”

However, Asthma UK and the British Lung Foundation Partnership said current guidelines from NICE “are not clear” about when people with severe asthma should be referred which means those most at risk are not getting the treatments they need.

Asthma UK and the British Lung Foundation director of research and innovation Dr Samantha Walker said: “Today’s news could be a real game-changer for the thousands of people with severe asthma across England, Wales and Northern Ireland who live in constant fear of a life-threatening asthma attack happening at any time.

“Severe asthma can have a colossal impact on people’s lives.

“People are stuck in a never-ending cycle of hospital visits, which has a serious and debilitating impact on their home, work and social life.

“While NICE’s decision to recommend dupilumab is cause for celebration, the sad fact is that four in five people with suspected severe asthma are not being referred to specialists for the treatments that could transform, and even save, their lives.

“Asthma UK and the British Lung Foundation is calling for NICE to develop new, clear guidelines so healthcare professionals are confident about when to refer patients with possible severe asthma to get the specialist care they so desperately need.

“If you’re experiencing severe asthma symptoms, Asthma UK and the British Lung Foundation has developed a new online tool to help you get on top of uncontrolled symptoms, work out whether you need to ask your doctor for extra help or a referral, and/or ask for specialist support.”

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