Tezepelumab as a treatment for severe, allergic asthma
Published: August 02, 2021
Allergy to year-round (or perennial) allergens is common in patients with severe asthma. In these patients, exposure to allergens triggers an inflammatory response that leads to asthma symptoms and potentially exacerbations (asthma attacks). Patients whose asthma is not controlled by treatment with high-dose, inhaled corticosteroids and other controllers may be given biologic therapies as an additional medication. Tezepelumab is a monoclonal antibody that has recently been approved in the United States for the treatment of severe, uncontrolled asthma. In clinical trials, tezepelumab reduced asthma exacerbations and improved lung function; however, it was unknown whether tezepelumab was beneficial to patients with perennial allergy.
In a recently published article in The Journal of Allergy and Clinical Immunology: In Practice, Corren et al. reported the results of a subsequent analysis of data from the PATHWAY study, a phase IIb, multicenter study in which 584 adults with severe, uncontrolled asthma were randomized to receive either tezepelumab or placebo for 52 weeks. In this analysis, the benefits of tezepelumab were compared in patients with perennial allergy versus those without. Additional analyses were performed with the patients grouped according to whether or not they were eligible to be treated with omalizumab, a biologic therapy that is specifically used to treat allergic asthma.
Compared with placebo, tezepelumab (210 mg every 4 weeks) reduced the asthma exacerbation rate by 78% in patients with perennial allergy and by 67% in those without it. Similar reductions in exacerbation rate were observed in patients who were eligible versus ineligible for treatment with omalizumab. Treatment with tezepelumab also resulted in improvements in lung function and reduced levels of inflammatory biomarkers in patients with perennial allergy as well as in those without. In all patients, differences between tezepelumab and placebo were observed as early as 4 weeks after treatment initiation and were sustained for at least one year.
In summary, this analysis provides further support for the benefits of tezepelumab in a broad population of patients with severe, uncontrolled asthma, including those with allergic asthma as well as those without allergy.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.