Real-world data on tezepelumab in patients with severe asthma in Germany

Background Tezepelumab is a novel biologic blocking thymic stromal lymphopoetin (TSLP), 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, multi-center 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 T2 biomarkers, 68.2% an allergic and 31.8% an eosinophilic phenotype. 23.3% of patients were biologic-naïve. 22 (18.2%) patients discontinued tezepelumab therapy due to suspected side-effects or insufficient efficacy. At 6 months follow-up, median reduction in annualized exacerbation rate (AE) was -1 [-2.9;0.0], the reduction of oral corticosteroid (OCS) dose among patients with long term OCS therapy was -5 mg [-10;0] and asthma control test (ACT) improved by 2 [0;5] points. 80.8% demonstrated a treatment response according to Biologic Asthma Response Score. There were no significant differences in treatment response between T2-high vs. T2 low, early vs. adult onset and eosinophilic vs. non-eosinophilic asthma. Prior treatment with other biologics was associated with inferior treatment response. Conclusion 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.