ORIGINALLY PUBLISHED
26 February 2021
Written by:
While recent treatment advances have helped millions of people worldwide better manage their asthma, we know many more remain underserved and continue to struggle – up to 26 million people worldwide are estimated to have severe asthma and approximately 20% of these patients may be uncontrolled.1-3 Now more than ever, we must urgently prioritise continued innovation in asthma research.
We’re doing this by innovating and building on our 50-year heritage in respiratory care to pursue scientific breakthroughs that will revolutionise our understanding of asthma. By understanding the pathophysiology of asthma and much-needed new advancements, we can improve patient care and outcomes.
Our bold research ambition is to eliminate preventable attacks among people with all severities of asthma and achieve on-treatment clinical remission.
New frontiers in research
In the past decade, scientific understanding of asthma has advanced considerably. Our knowledge of the complex biology behind asthma inflammation has led to an appreciation of the heterogeneous nature of the disease and the identification of a broad range of asthma phenotypes, marked by different drivers of airway inflammation.4-7
From this knowledge, the discovery of several biologic therapies has provided much-needed solutions for many severe asthma patients. However, there remains vast potential to improve treatment particularly for patients with unknown, unclear, or multiple drivers of inflammation.5-8 That’s why we’re working to further expand scientific knowledge around the drivers and biological mechanisms of asthma to tackle the disease pathophysiology in new and powerful ways.
The importance of eosinophils' role in asthma is now well-established: as common effector cells, eosinophils contribute to airway dysfunction and tissue remodelling found in asthma.9-13 Researchers are improving knowledge of eosinophilic asthma and the link to other related inflammatory diseases that share common pathways and disease drivers.9,14 By improving awareness of these related pathologies, we believe our research will lead not only to innovative understanding of this complex area but also to earlier detection and intervention for those affected.
Advancing epithelial science
Epithelial science is a new frontier in asthma research, and biologists are working to better characterise the key role of the airway epithelium.15-19
We’re building on our understanding of epithelial biology by modelling the airway in vitro. This will allow us to better examine cell abnormalities, along with the effects of cytokines on cellular processes.20 We’re also investigating non-invasive nasal sampling technology to assess detection of epithelial cytokines following exposure to an allergen.21 There are many benefits to non-invasive sampling, including that it is easy to perform and thus suitable for frequent sampling.21
Together, this and our other ongoing research, will help us to better understand the role of the epithelium in asthma (and potentially other inflammatory diseases). This research is crucial in expanding our knowledge and providing new focus to help target the remaining unmet needs in asthma.
Next-generation therapeutics
Beyond understanding underlying biology, there are three key areas in which we are innovating to develop our next generation therapeutics and achieve our long-term goal of disease modification and clinical remission.
We are looking at new drug modalities such as bispecific fragment antibodies and Anticalin® proteins to complement the more established small molecules and monoclonal antibodies (mAbs) treatments.
We're leveraging multiple highly phenotyped cohorts which include human genomic data sets, such as those from our real-world NOVELTY trial. Also, we’re using machine learning to identify new targets and through the identification of new patient subgroups, advance the development of precision medicines for asthma.22,23 We will soon be able to move beyond identifying eligible patients by traditional biomarkers such as eosinophils, fractional exhaled nitric oxide (FeNO) and serum immunoglobulin E (IgE). Instead, matching patients to treatments via biomarkers including genetic signatures, enabling physicians to deliver the right treatment to the right patient at the right time.21,24
Accelerating the speed at which these new therapy directions reach patients is vital, and creating the next generation of clinical trials by leveraging digital health tools to enhance our capabilities around running virtual trials. This decentralised approach allows people to take part in a way that's more convenient for them whilst also using transformative endpoints to demonstrate disease modification.25
The future of asthma
We know that many people with asthma are underserved today and that asthma remains a significant public, and personal, health challenge.1,26 As pioneers in asthma, we are committed to continuing to push the boundaries of science to transform the lives of people living with this condition and give them a better future with the care they deserve.