Efficacy of tezepelumab in patients with severe allergic asthma in clinical practice

Introduction: Tezepelumab is a human monoclonal immunoglobulin G2λ antibody that targets the cytokine thymic stromal lymphopoietin (TSLP). In clinical trials, tezepelumab has been shown to reduce the annualized asthma exacerbation rate in patients with both high and low levels of T2 inflammation biomarkers. Methods: This is a prospective, multicenter study of RE-ASGRAMUR (Register of Severe Asthma of the Region of Murcia) conducted under routine clinical practice conditions. We analyzed exacerbations, changes in lung function (pre-bronchodilator FEV1), asthma control (ACT), and quality of life (mini AQLQ). In addition, T2 biomarkers, including blood eosinophils and exhaled nitric oxide (FeNO), were analyzed. Results: We present a series of 38 patients with severe allergic asthma who received treatment with tezepelumab. More than half of these patients had previously shown inadequate responses to other biologic therapies. Following treatment, the annualized rate of exacerbations decreased markedly from a baseline mean of 2.2 to 0.28, representing an 86.8% reduction. The Asthma Control Test (ACT) score improved by an average of 5.2 points, while the mini Asthma Quality of Life Questionnaire (miniAQLQ) score increased by 1 point. Pulmonary function also improved significantly, with a mean increase of 170 mL in FEV1. Furthermore, type 2 inflammatory biomarkers, including blood eosinophil counts and fractional exhaled nitric oxide (FeNO), showed a significant reduction. Conclusions: Tezepelumab is an effective treatment for severe allergic asthma, improving exacerbations, disease control, quality of life, and lung function.