There may be a silver lining for asthma sufferers after $130 billion capped CSL Limited announced it is developing a drug to stop inflammation in the lungs that triggers the condition.
Australia’s biggest health company and third largest company on the ASX is now targeting the $US21.6 billion ($33.54 billion) asthma market, along with the 2.7 million people (more than 10%) who suffer from asthma in Australia.
CSL aims to move people away from long-term use of traditional steroid therapies with its drug currently known as trabikibart or CSL311.
A further benefit is the prevention of steroid-based side effects which include impaired growth in children and cataracts among other issues.
The treatment would see a more personalised approach to asthma management.
“That’s the key with asthma therapies at the moment: being able to go to the clinicians and patients and say we recognise that you’ve got a particular type of asthma and our drug will be targeted towards the asthma you’ve got,” chief scientific officer Andrew Nash said.
“It’s a pretty competitive space, asthma. Some types of asthma are reasonably well treated at the moment but there are still areas of asthma that are very poorly treated with current drugs, whether they’re your more traditional inhaled corticosteroids or some of the newer-generation monoclonal antibodies.
“There are subsets of asthma that are still treated equally poorly and that’s what we are aiming at here.”
Clinical trials and development
CSL has initiated a phase one clinical trial for its groundbreaking asthma treatment, following delays caused by the COVID-19 pandemic. Established a century ago as the Commonwealth Serum Laboratory and later listed on the ASX in the 1990s, CSL invests about $1 billion annually in research and development.
The asthma therapy involves a recombinant antibody that blocks multiple receptors, disrupting the lung inflammation responsible for severe asthma attacks. This distinguishes it from existing therapies targeting a single receptor.
"We're the first ones targeting the beta-common receptor, offering the opportunity to intervene in various biochemical and cell pathways," said Dr Nash.
“The reason it’s interesting is it’s a receptor for three soluble factors that mediate inflammation. Often it’s a monoclonal antibody-based drug and monoclonal antibodies target a single mechanism of action.
“So we think it’s novel and has the opportunity to intervene in a number of different biochemical and cell pathways.”
The therapy was co-developed with SA Pathology’s Centre for Cancer Biology, a CSL collaborator for 20 years. Angel Lopez from SA Pathology highlighted the drug's potential to control severe asthma attacks without the long-term use of steroids.
“Asthma is an inflammatory disease, which means there are cells in the blood that attack the body, and in asthma, the part of the body these cells are attacking is the lungs. The reason they attack the lung is that they’re revved-up, super-activated and really nasty, as well as a little bit blind – hurting ourselves,” Professor Lopez said.
“This antibody switches them off – it effectively applies the brakes. The cells are still there, we’re not wiping them out because if you do you might facilitate infection, but they are better controlled and less revved-up.”
“The big thing is you could get away from long-term use of steroids, and some people don’t respond to steroids anyway, so we are very excited about this current project.”
The development timeline estimates public availability in five years, pending successful completion of three clinical trial phases and regulatory approval. The global asthma therapeutics market, valued at US$21.6 billion last year, is projected to reach US$30.6 billion by 2032, according to Acumen Research and Consulting.
While respiratory disease is one of CSL's key focus areas, alongside immunology and hematology among others, it should be noted that some of the company's research endeavors have been discontinued in the past.