Tezepelumab effective as Add-On Therapy in Both T2-High and T2-Low Severe Asthma: Study

According to a real-world study, tezepelumab is an effective add-on biologic with a rapid onset of action for patients with both T2-high and T2-low severe asthma. The study was published in International Immunopharmacology by Pelaia and colleagues.

The trial involved 30 patients who had been diagnosed with either T2-high or T2-low severe asthma. Patients were evaluated at baseline and subsequently after 4 weeks of tezepelumab add-on therapy. The clinical symptom control, asthma-related quality of life, lung function, inflammatory biomarkers, and use of oral corticosteroid (OCS) were among the assessments. The participants were recruited from a single centre and comprised those who had and had not received prior treatment with other biologic drugs.

Markers of inflammation also showed significant reductions. Fractional exhaled nitric oxide (FeNO), the eosinophilic airway inflammation biomarker, declined significantly. Counts of blood basophils, another indicator of allergic and inflammatory reaction, also decreased. In cytokines, serum levels of interleukin-2 (IL-2) and vascular endothelial growth factor (VEGF) were significantly decreased, evidencing the extensive immunomodulatory actions of tezepelumab.

Key Findings

 • 30 patients with severe asthma were assessed

• Substantial symptom improvement quantified by ACT score and AQLQ

• Improved lung function: FEV1, FEF25–75, and Rtot

• Reduced inflammatory markers: FeNO, basophil count

• Decreased cytokines: IL-2, VEGF

• Effects observed in both T2-high and T2-low patients

• Beneficial regardless of previous biologic use

Efficacy Across Asthma Phenotypes

Significantly, the study confirmed that the benefits of tezepelumab extended to both T2-high and T2-low phenotypes of severe asthma. In addition, the drug’s efficacy was unaffected in patients whether they had been exposed to prior use of other biologic medicines or not. This highlights tezepelumab’s sole strength: it neither depends on eosinophilic nor allergic biomarkers to act on patients with severe asthma. Hence, it is a therapy universally applicable across all cases of severe asthma.

In this real-world investigation, tezepelumab demonstrated rapid and robust improvements in asthma control, lung function, and inflammatory markers for both T2-high and T2-low phenotypes. Its efficacy, irrespective of previous biologic exposure, attests to its utility as a useful add-on treatment with widespread use in severe asthma. Future long-term research may further confirm such encouraging initial findings and optimize its placement within asthma treatment guidelines.

Reference:

Pelaia, C., Greco, M., Iaccino, E., Crimi, C., Biafora, M., Dragone, F., Vatrella, A., & Pelaia, G. (2025). Short-term therapeutic effectiveness of tezepelumab in patients with severe asthma: A real-world study. International Immunopharmacology, 162(115185), 115185. https://doi.org/10.1016/j.intimp.2025.115185
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