New class of drug shows promise for treating asthma and COPD

Scientists have developed a new drug (RPL554) that could treat obstructive airway diseases such as asthma and chronic obstructive pulmonary disease (COPD) in two ways at once, according to new research published in The Lancet Respiratory Medicine. RPL554 has the potential to both reverse the narrowing of the airways (bronchodilation) and reduce inflammation quicker and with fewer side effects than current therapies.

"Further longer term studies of RPL554 are now eagerly awaited because this could be one of the most substantial advances for some time in the management of patients with chronic airway obstruction", writes Professor Jadwiga A Wedzicha from University College London, UK, in a linked Comment.

The unique inhaled dual inhibitor—two actions in a single molecule—works by impeding the ability of two enzymes from the phosphodiesterase family (PDE3 and PDE4) to inhibit processes that help relax airway smooth muscle and reduce inflammation.

For the past 40 years, the mainstay of treatment for and COPD (eg, chronic bronchitis and emphysema) has been inhaled anti-inflammatory drugs (corticosteroids) plus bronchodilators (usually long-acting ß2 agonists). But corticosteroids can have substantial , while long-acting ß2 agonists have come under scrutiny for their risk of worsening . What is more, most people with severe disease and frequent flare-ups fail to achieve good control of symptoms and new treatments are needed.

Between February, 2009 and January 3013, four small proof-of-concept clinical trials were done in the Netherlands, Italy, and the UK to assess the safety and efficacy of inhaled RPL554 in healthy participants (39 people) and people with mild-to-moderate asthma (28) and COPD (12).

In COPD patients, a single dose of nebulised RPL554 improved respiratory function, producing a 17% increase in FEV1 (forced expiratory volume at 1 second; which measures the volume of air that can be forcibly exhaled in one second after taking a deep breath)—a bronchodilator response at least as effective as the widely use ß2 agonist Salbutamol.

Additionally, in patients with asthma and COPD, there was rapid bronchodilation with peak effects similar to those produced with inhaled ß2 agonists. Repeat dosing in asthmatics for 6 days showed that the bronchodilator effects were maintained.

Findings also showed that RPL554 can inhibit the bacterial component lipopolysaccharide (LPS) in healthy subjects suggesting that RPL554 also possesses significant anti-inflammatory activity.

Overall, RPL554 was well tolerated and patients in the treatment and placebo groups experienced similar rates of adverse events, which were generally mild. "Although other PDE4 inhibitors can cause gastrointestinal side effects when given orally, none were reported at any dose of RPL554 tested in these trials", explains study leader Professor Clive Page from King's College London, UK.

According to Professor Page, "These studies give us a glimpse into the potential , bronchoprotective, and anti-inflammatory effects of this drug. So far trials have run for 7 days or less and there is a need to look at longer-lasting effects. Further studies are needed to better understand the full potential of this new therapy for COPD and asthma."**

More information: www.thelancet.com/journals/lanres/article/PIIS2213-2600(13)70187-5/abstract

add to favorites email to friend print save as pdf

Related Stories

Visualizing how infection exacerbates lung disease

Aug 23, 2013

Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. The disease, characterized by constricted airways due to bronchitis and emphysema, is commonly seen in smokers but can also ...

Recommended for you

Thyroid disease risk varies among blacks, Asians, and whites

8 hours ago

An analysis that included active military personnel finds that the rate of the thyroid disorder Graves disease is more common among blacks and Asian/Pacific Islanders compared with whites, according to a study in the April ...

The key to easy asthma diagnosis is in the blood

11 hours ago

Using just a single drop of blood, a team of University of Wisconsin-Madison researchers has developed a faster, cheaper and more accurate tool for diagnosing even mild cases of asthma.

Younger adults hit hardest this flu season

13 hours ago

(HealthDay)—The H1N1 flu was the predominant influenza strain in the United States this year, but it packed a lot less punch than in 2009 when it caused a worldwide pandemic, health officials report.

User comments