Early response to Tezepelumab in type-2 severe asthma patients non-responders to other biological treatments: a real-life study

Abstract

Background

Biologic therapies play a crucial role in the treatment of severe asthma. Tezepelumab, a human monoclonal antibody (mAb), inhibits thymic stromal lymphopoietin, a pivotal factor in the pathophysiology of asthma. Although randomized clinical trials have demonstrated the efficacy of Tezepelumab, evidence gaps remain in real-world scenarios.

Objective

We sought investigate Tezepelumab’s response in a clinical setting, focusing on patients who previously failed to other asthma mAbs.

Methods

Real-life study with severe uncontrolled asthma patients despite mAb treatment, requiring a switch to Tezepelumab. Follow-up was done four to six months after initiation of Tezepelumab. The primary endpoint was to evaluate the response in patients with poor response or intolerance to other mAbs.

Results

Nine patients were followed up during 7 months. Patients were predominantly middle-aged females with eosinophilic or eosinophilic-allergic phenotypes. Patients had a median failure rate of 2 mAbs (IQR 2–3), with an uncontrolled asthma (median of 2 severe exacerbations the previous year, airflow obstruction and 78% corticosteroid dependence). Tezepelumab demonstrated after 4 to 6 months of treatment reduce corticosteroid dependence (complete withdrawal in 2/7 patients), no exacerbations in 6/9, symptoms control improvement (Asthma Control Test score improved in 5/9) and modulate lung function (improving in 3/9 patients). These findings align with clinical trial results, suggesting Tezepelumab’s potential in real-world settings.

Conclusion

In real-world scenarios, despite the study’s limitations, our results underscore Tezepelumab’s promise as a therapeutic option for uncontrolled severe asthma, and may be useful for non-responders to other mAbs. Further studies are needed to corroborate these findings.

Keywords:

• Tezepelumab
• biologic treatment
• severe uncontrolled asthma

Declaration of interest

RMDC been received speaker’s honoraria from AstraZeneca, GEBRO, GSK, Sanofi Genzyme. IGM has been on Advisory boards of (alphabetic order): AstraZeneca, GSK, Novartis, Sanofi Genzyme, Stallergenes. IGM has been received speaker’s honoraria from (alphabetic order) Allergy therapeutics, ALK-Abelló, AstraZeneca, Chiesi, GSK, Leti, Mundipharma, Novartis, Orion Pharma, Pfizer, Sanofi Genzyme, Stallergenes, and Teva. AGDA been received speakers’ honoraria from GSK.

MJG, CFR, JFC has no conflicts of interest to disclose.