Does Tezepelumab work for severe uncontrolled asthma?

Question

Hello doctor,

My wife is 38 years old and has severe asthma that has become completely uncontrolled despite receiving maximum medical therapy. She is currently prescribed Fluticasone furoate twice daily, Spiriva, Montelukast, and Theophylline, and has been taking Prednisone 20 mg daily for the past four months. Unfortunately, the Prednisone is causing severe side effects, including significant weight gain, mood swings, easy bruising, and insomnia.

Despite all of these treatments, she still requires albuterol nebulizer treatments four to five times per day and has been hospitalized three times this year, each time requiring bilevel positive airway pressure (BiPAP) support.

Her pulmonologist recently recommended initiating Tezepelumab (Tezspire) after laboratory testing revealed an elevated eosinophil count of 750 cells/µL and negative results for specific allergen sensitivities. She has previously been treated with other biologics, including Benralizumab and Mepolizumab, but derived minimal benefit from both.

Our concerns are as follows:

Will Tezspire be effective when previous biologic therapies have failed?
How long does it typically take to notice improvement after starting Tezspire?

She is a teacher but has been forced to take medical leave because she cannot speak without triggering severe bronchospasm. We are also very concerned about the risk of infection, as she experiences frequent episodes of bronchitis.

Her most recent pulmonary function tests (PFTs) revealed a forced expiratory volume in one second (FEV1) of only 48 percent predicted, and her oxygen saturation dropped to 89 percent with minimal exertion.

We are feeling desperate, as the side effects of long-term Prednisone use have become increasingly intolerable and are severely impacting her quality of life. We would greatly appreciate any guidance or insight regarding the potential role of Tezspire in her treatment and any additional steps we can consider at this stage. Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Tezepelumab (Tezspire) is a biological medication, meaning it is developed from living cells. It is intended for individuals with severe asthma symptoms that remain uncontrolled despite the use of standard asthma therapies.

Please note that Tezspire is not an emergency medication and does not provide relief during acute asthma attacks. However, it plays an important role in the prevention of severe asthma exacerbations and long-term management of the condition.

Tezspire has been shown to be more effective than some of the previously available biological treatments, although it may still cause certain side effects. Fortunately, most reported side effects are generally mild, tolerable, and manageable.

Based on your wife's current condition, you may consider initiating this treatment under the guidance of her healthcare provider.

Regarding the use of corticosteroids, it is true that Prednisone can lead to several adverse effects, including those your wife is experiencing, such as weight gain, mood changes, easy bruising, and insomnia. Unfortunately, in cases of uncontrolled asthma, corticosteroids often remain necessary, and at this stage, reducing the steroid dose may not be feasible.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.