Rachel’s asthma was so se­vere she couldn’t climb stairs. Now, thanks to a rev­o­lu­tion­ary jab, she can climb Ben Ne­vis

The Scottish Mail on Sunday - - Health - By Matthew Bar­bour and Fiona MacRae

THREE new drugs are rev­o­lu­tion­is­ing the lives of Bri­tons with a dev­as­tat­ing form of asthma. Un­like other medicines, which merely ad­dress the symp­toms, these get to the very heart of the con­di­tion – with re­mark­able re­sults.

The lat­est break­through came last week when NHS chiefs in Eng­land gave the green light to ben­ral­izumab, also known by the brand name Fasenra, a monthly jab that helps suf­fer­ers who have ex­hausted all other treat­ment op­tions and are reg­u­larly hos­pi­tal­bound due to breath­ing prob­lems.

The drug joins mepolizumab, or Nu­cala, and reslizumab, also called Cin­qaero, which were ap­proved two years ago to treat eosinophilic asthma, a se­vere form of the dis­ease.

The Scot­tish Medicines Con­sor­tium has ap­proved mepolizumab for ex­treme asthma cases but re­jected reslizumab. It has yet to con­sider ben­ral­izumab.

The drugs’ ben­e­fits can be dra­matic. Rachel McCarthy, a 43-yearold com­pany di­rec­tor, has gone from be­ing barely able to climb the stairs to climb­ing moun­tains since be­ing pre­scribed mepolizumab.

She says: ‘Within three months I no­ticed a dra­matic im­prove­ment and in June last year I climbed Ben Ne­vis, some­thing that had been be­yond my wildest dreams.

‘To stand on the top as an asth­matic and breathe the most won­der­ful air into my lungs was the most beau­ti­ful thing in the world.’

Ex­perts are in­creas­ingly aware that asthma isn’t just one dis­ease but a col­lec­tion of con­di­tions that need to be treated dif­fer­ently.

Eosinophilic asthma can’t be con­trolled with nor­mal in­halers, even at high doses. As a re­sult, the 100,000 Bri­tons with the con­di­tion are of­ten pre­scribed pow­er­ful steroid pills which risk side ef­fects from di­a­betes and weight gain to mood swings and os­teo­poro­sis. How­ever, many still end up in hos­pi­tal with life-threat­en­ing at­tacks.

Eosinophilic asthma, which nor­mally de­vel­ops in adult­hood, is trig­gered by in­flam­ma­tion-caus­ing white blood cells called eosinophils gath­er­ing in the air­ways.

The three new drugs are man­made an­ti­bod­ies de­signed to block IL-5, an im­mune sys­tem chem­i­cal that at­tracts eosinophils to the air­ways and helps them thrive. In tri­als, the drugs halved the num­ber of at­tacks pa­tients suf­fered and sig­nif­i­cantly im­proved qual­ity of life.

They are pre­scribed by spe­cial­ist cen­tres and given as jabs or in­fu­sions ev­ery four to eight weeks in hos­pi­tal. If they work, pa­tients can cut back on their oral steroids. How­ever, they still have to take their in­halers. Side ef­fects in­clude tired­ness, headaches, fa­tigue and back pain, and in­creased sus­cep­ti­bil­ity to in­fec­tions.

Mepolizumab, reslizumab and ben­ral­izumab be­long to a class of drugs known as bi­o­log­ics, and they work in slight dif­fer­ent ways. Re­searchers are try­ing to work out how to en­sure a pa­tient gets the one that is best for them. They are also try­ing to cre­ate ver­sions that can be given at home rather than in hos­pi­tal. Dr Saman­tha Walker, di­rec­tor of re­search at char­ity Asthma UK, said that while bi­o­log­ics are not a cure and do not work for ev­ery­one, in some peo­ple the ef­fects are lifechang­ing. ‘I’ve known peo­ple with se­vere asthma to give up work or re­tire ten years early,’ she says. ‘Peo­ple get slower and slower be­cause they don’t want to not be able to breathe.’

Dr Walker added: ‘For those who re­spond to bi­o­log­ics, they re­ally are game-chang­ing.’

Rachel’s asthma was so se­vere that she stopped so­cial­is­ing, gave up play­ing sport and could barely get up the stairs. She says: ‘I had my first asthma at­tack at 22, and since then my asthma took over my life. By my 30s I was be­ing ad­mit­ted to hos­pi­tal on a monthly ba­sis with se­vere at­tacks.

‘I was put on high-strength steroids, and al­though they helped me to breathe, they made me put on a lot of weight and left me very de­pressed. My hus­band Rick knows only too well that at times I felt like I couldn’t go on.’

Since start­ing monthly in­jec­tions of mepolizumab in Oc­to­ber 2017, she has stopped tak­ing steroids, gone back to the gym, dropped two dress sizes – and climbed Bri­tain’s high­est moun­tain. The dra­matic im­prove­ment in her health also means that a long-held dream to have a fam­ily has be­come a pos­si­bil­ity.

‘It’s hard to take in how this new drug has given me my life back af­ter so many years of lit­er­ally want­ing my life to be over,’ says Rachel, from Lin­coln.

Mein­dert Boy­sen, head of tech­nol­ogy eval­u­a­tion at Eng­land’s NHS drugs watch­dog, the Na­tional In­sti­tute for Health and Care Ex­cel­lence, says: ‘Peo­ple with se­vere eosinophilic asthma that is in­ad­e­quately con­trolled of­ten have se­verely im­paired qual­ity of life . . . By keep­ing their asthma bet­ter un­der con­trol, bi­o­log­i­cal treat­ments have trans­formed the lives of these suf­fer­ers.’

Asthma UK funds re­search into the de­vel­op­ment of ground-break­ing asthma treat­ments. To do­nate, visit asthma.org.uk/do­nate.

It’s given me my life back… af­ter years of want­ing it to be over

NEW HEIGHTS: Rachel McCarthy, be­low, and, above, cel­e­brat­ing at the sum­mit of Ben Ne­vis

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