Real-world evidence of tezepelumab for severe asthma: a retrospective multicentre cohort.

Abstract

Background: Tezepelumab, a monoclonal antibody targeting thymic stromal lymphopoietin, has demonstrated efficacy for severe asthma in clinical trials, but real-world evidence remains limited. We aimed to evaluate the characteristics and outcomes of patients initiating tezepelumab in a real-world setting.

Methods: We conducted a retrospective, multicentre cohort study across four tertiary care centres to evaluate the real-world effectiveness of tezepelumab in patients with severe asthma. Eligible patients were adults with a confirmed diagnosis of severe asthma, treated with tezepelumab. Data on exacerbation rates, pulmonary function and corticosteroid use were collected and analysed at baseline and 1-year follow-up.

Results: The study included 103 patients treated with tezepelumab with a median (interquartile range) duration of 323 (267-359) days. Overall, 39% had prior biologic therapy and 32% had an eosinophil count <300 cells·μL^-1. At follow-up, there was a 66.7% relative reduction in annual exacerbations. The most pronounced reduction was observed in biologic-naïve patients with peripheral eosinophil counts ≥300 cells·μL^-1 (78% reduction). A 62% relative reduction was found among patients with eosinophil counts <150 cells·μL^-1. There were significant improvements in forced expiratory volume in 1 s, with 51% of patients demonstrating a ≥10% relative increase. Of patients using maintenance oral corticosteroid (mOCS), 45% discontinued mOCS and 23% reduced their dose by more than 50%.

Conclusions: In this real-world cohort, treatment with tezepelumab for a median of 46 weeks was associated with improved asthma control, reductions in exacerbations, mOCS and inhaled corticosteroid doses, and a low symptom burden. These findings were consistent in biologic-experienced or low-eosinophil patients.