Real-World Data on Tezepelumab in Patients With Severe Asthma in Germany

BACKGROUND: Tezepelumab is a novel biologic blocking thymic stromal lymphopoetin, approved for severe asthma irrespective of biomarker levels or phenotype. OBJECTIVE: To characterize a real-world tezepelumab patient cohort and the efficacy among various asthma phenotypes. METHODS: We performed a retrospective, multicenter study on patients with severe asthma initiating tezepelumab. Clinical response was evaluated at 3 and 6 months. RESULTS: We included 129 patients with an average age of 52.5 - 13.1 years, 59.7% were female. The majority (86.0%) had increased type 2 (T2) biomarkers, 68.2% an allergic and 31.8% an eosinophilic phenotype. 23.3% of patients were biologic- naive. 22 (18.2%) patients discontinued tezepelumab therapy owing to suspected side effects or insufficient efficacy. At 6 months' follow-up, median reduction in annualized exacerbation rate was-1 [25th percentile; 75% percentile {-2.9; 0.0}], the reduction of oral corticosteroid dose among patients with longterm oral corticosteroid therapy was-5 mg [-10; 0] and the Asthma Control Test (ACT) improved by 2 [0; 5] points. A treatment response according to Biologic Asthma Response Score of 80.8% was demonstrated. There were no significant differences in treatment response between T2-high versus T2 low, early- versus adult-onset and eosinophilic versus noneosinophilic asthma. Prior treatment with other biologics was associated with inferior treatment response. CONCLUSIONS: In this real-life cohort, including a large proportion of patients with history of previous biologic use and encompassing various subgroups, the majority responded to tezepelumab. Our data further suggest a steroid-sparing effect of tezepelumab. (c) 2024 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY- NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/). (J Allergy Clin Immunol Pract 2024;12:2399-407)