Monthly monoclonal antibody injection tezepelumab is so effective in patients with severe asthma, half of them are able to stop daily steroid tablets altogether, researchers have found.
An international trial, led by UK researchers, found that the vast majority of patients taking tezepelumab were able to reduce their doses of other medication and improvements were seen as early as two weeks.
Reporting the findings of the year-long trial in The Lancet Respiratory Medicine, the researchers said 32% of patients had discontinued oral corticosteroid treatment after 28 weeks without impact on asthma control and 50% had stopped after a year.
Tezepelumab was also shown to produce ‘rapid and sustained improvements’ in asthma symptoms, lung function, and overall quality of life with two-thirds of patients stopping having any asthma attacks.
Almost 300 patients with severe uncontrolled asthma received the injections every four weeks in the study which found after 12 months, nearly 90% had a maintenance oral corticosteroid dose of 5 mg per day or less.
The tapering of oral corticosteroid doses was done on a personalised basis with regular testing to manage the risk of adrenal insufficiency – a protocol that could help guide its use in the real world.
Study lead Professor David Jackson, clinical lead of the asthma services at Guy’s and St Thomas’ NHS Foundation Trust and professor of respiratory immunology at King’s College London, said the trial was an ‘important step forward’.
‘In this International, multicentre clinical trial of more than 300 patients, the NICE-approved asthma treatment tezepelumab, a biologic therapy that targets asthma-related inflammation but without all the side effects of steroids, was capable of allowing the vast majority of patients to wean their steroids down to a low dose with over half able to stop their steroids altogether.
‘As tezepelumab also suppresses allergy related symptoms and improves chronic rhinosinusitis as well, the results are particularly exciting for patients with severe asthma who suffer with both upper and lower airway symptoms,’ he added.
NICE recommended tezepelumab in 2023 for patients with severe asthma when treatment with high-dose inhaled corticosteroids plus another maintenance treatment has not worked and patients are continuing to have three or more exacerbations in a year.
Professor Kamila Hawthorne, RCGP chair said the prospect of a monthly injection, rather than daily tablets, may be a ‘more manageable treatment option’ for some patients.
‘As with any emerging research, it’s important the findings are carefully assessed and considered as clinical guidelines, which GPs use in their daily practice, are developed and updated, based on the latest evidence to ensure safety and benefit for patients.’
Dr Samantha Walker, director of research and innovation at Asthma + Lung UK, said: ‘This study is a promising sign that tezepelumab injections support certain people with severe asthma to reduce or stop taking steroid tablets, which can have serious unwanted health consequences.’
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