Department of Internal Medicine II, Cardiology, Pneumology, Angiology, University Hospital Bonn, Bonn, Germany.
Department of Medicine V, Ludwig-Maximilians-Universität (LMU) University Hospital, LMU Munich, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), Munich, Germany.
J Allergy Clin Immunol Pract. 2024 Sep;12(9):2399-2407.e5. doi: 10.1016/j.jaip.2024.05.052. Epub 2024 Jun 10.
Tezepelumab is a novel biologic blocking thymic stromal lymphopoetin, approved for severe asthma irrespective of biomarker levels or phenotype.
To characterize a real-world tezepelumab patient cohort and the efficacy among various asthma phenotypes.
We performed a retrospective, multicenter study on patients with severe asthma initiating tezepelumab. Clinical response was evaluated at 3 and 6 months.
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 long-term 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 non-eosinophilic asthma. Prior treatment with other biologics was associated with inferior treatment response.
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.
特泽佩鲁单抗是一种新型生物制剂,可阻断胸腺基质淋巴细胞生成素,适用于不论生物标志物水平或表型如何的重度哮喘。
描述特泽佩鲁单抗真实世界患者队列,并评估各种哮喘表型中的疗效。
我们对开始接受特泽佩鲁单抗治疗的重度哮喘患者进行了回顾性、多中心研究。在 3 个月和 6 个月时评估临床应答。
我们纳入了 129 例平均年龄为 52.5±13.1 岁的患者,其中 59.7%为女性。大多数(86.0%)患者存在 2 型(T2)生物标志物增加,68.2%为过敏性表型,31.8%为嗜酸性粒细胞表型。23.3%的患者之前未使用过生物制剂。22 例(18.2%)患者因疑似副作用或疗效不足而停用特泽佩鲁单抗治疗。在 6 个月的随访中,年化加重率中位数降低了-1[25 分位数;75 分位数{-2.9;0.0}],长期口服皮质类固醇治疗患者的口服皮质类固醇剂量减少了-5 mg[-10;0],哮喘控制测试(ACT)提高了 2 分[0;5]。根据生物哮喘应答评分,治疗应答率为 80.8%。T2 高与 T2 低、早发型与成年发病型和嗜酸性粒细胞与非嗜酸性粒细胞哮喘之间的治疗应答无显著差异。先前使用其他生物制剂与治疗应答较差相关。
在本真实世界队列中,包括了很大比例的有既往生物制剂使用史的患者,并涵盖了各种亚组,大多数患者对特泽佩鲁单抗有应答。我们的数据进一步表明特泽佩鲁单抗具有类固醇节省效应。