Is Tezepelumab effective for acute asthma flare-ups?

Question

Hello doctor,

A 22-year-old male with status asthmaticus was admitted to the ICU (intensive care unit) and intubated. He is currently on Tezspire (4th month of treatment), which has been keeping his asthma well-controlled until now. The exacerbation was triggered by a viral upper respiratory infection. He is being treated with mechanical ventilation, continuous Albuterol, and IV steroids. His usual medications include Fluticasone/Salmeterol, Montelukast, and Tezspire.

Questions to consider:

Should Tezspire be continued during this acute asthma flare-up?
How does this affect his recovery and the plan for extubation?
How should the schedule for biological treatment be adjusted after discharge?
What additional tests or evaluations are needed to prevent future severe asthma attacks?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Given the severity of the patient's asthma attack, it is reasonable to temporarily stop Tezepelumab (Tezspire) until their condition improves. Once the patient's condition stabilizes, review the need for Tezspire and decide if treatment should be resumed.

Tezspire does not directly help with bronchodilation or extubation planning. The priority should be on standard treatments, such as mechanical ventilation, continuous Albuterol, and IV (intravenous) steroids, to manage the acute exacerbation. After recovery, evaluate how well Tezspire worked and adjust the treatment schedule or dosage if needed. Depending on the patient's response and the severity of the exacerbation, consider adding or modifying other treatments like bronchodilators, anti-inflammatory medications, or additional biologics.

Additional workups to prevent future severe exacerbations include:

1. Identify triggers or investigate what triggered the exacerbation (for example, viral infection) and develop strategies to reduce their impact in the future.

2. Ensure proper inhaler use; make sure the patient is using their inhalers correctly and consistently.

3. Consider allergy testing if not done already, allergy testing may help identify any allergens contributing to the patient's asthma.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.