Tezepelumab Improves Asthma Control, Reduces Reliance on Oral Corticosteriods

Results presented at the American College of Chest Physicians (CHEST) 2025 Annual Meeting show that tezepelumab (Tezspire; AstraZeneca, Amgen) improves asthma control while simultaneously reducing the reliance on oral corticosteroids (OCS) among adults with severe asthma. These data were from the WAYFINDER clinical trial (NCT05274815) and further support the use of tezepelumab in the treatment of severe asthma.^1,2

Tezepelumab is a human monoclonal antibody that blocks thymic stromal lymphopoietin activity. It is indicated for use alongside other asthma medicines for the maintenance treatment of severe asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) in patients 12 years and older whose asthma is not controlled with their current treatment. It is not a rescue medication; it helps prevent severe asthma attacks or exacerbations and improve breathing in those with asthma, and reduce the size of polyps, improve symptoms (eg, nasal congestion, loss of smell), and reduce the need for OCS and surgery in those with CRSwNP.^3,4

WAYFINDER is an open-label, single-arm, multicenter phase 3b clinical trial that enrolled adults with severe asthma to evaluate the safety and efficacy of tezepelumab in reducing OCS use (prednisone/prednisolone 5–40 mg/day or equivalent) in this population. Patients received 210 mg of subcutaneous tezepelumab every 4 weeks for up to 52 weeks, and following a 4-week induction phase on a stable OCS dose, participants entered a 48-week OCS reduction and maintenance phase.^2,3

The coprimary end points, which were assessed at weeks 28 and 52, were the proportion of participants who reduced their daily prescribed maintenance OCS dose to 5 mg or less per day without loss of asthma control and the proportion of participants who discontinued OCS without loss of asthma control. During the reduction phase, OCS dose reductions were less than 5 mg per day and were contingent on participants retaining adrenal function, which was assessed via an initial morning cortisol test and either adrenocorticotropic hormone stimulation tests or repeated morning serum cortisol tests.³

A total of 298 patients initiated treatment with tezepelumab, and 273 completed the study in its entirety. The findings showed that the mean maintenance OCS dose was about 10.8 mg per day, and approximately 88.9% and 89.9% of patients had a maintenance dose of 5 mg or less per day at weeks 28 and 52, respectively. Additionally, 82.2% of patients who had a maintenance OCS dose of 5 mg or less per day did not experience loss of asthma control at week 52 when the reason for systemic corticosteroid treatment was specifically related to adrenal insufficiency.³

Additionally, at baseline, only 3.0% of participants had well-controlled asthma. By week 28, this rose to 25.5%, and by week 52, approximately 26.9% of patients achieved well-controlled status. Over the same period, the proportion with uncontrolled asthma dropped from 80.2% to 34.9%. The mean Asthma Control Questionnaire-6 score improved from 2.6 at baseline to 1.5 at week 28 and 1.4 at week 52, demonstrating both a meaningful and sustained reduction in symptom burden. Approximately 47.3% of study participants achieved at least partially controlled asthma by the end of the trial.¹ Of note, the safety profile of tezepelumab was observed to be consistent with previous studies.³

These data support the potential of tezepelumab when used as a biologic therapy for patients struggling with steroid dependence and persistent inflammation despite maximal standard therapy. For health care professionals who manage severe asthma, the WAYFINDER findings highlight tezepelumab’s dual benefit when improving asthma control and reducing OCS exposure, both of which are crucial in minimizing treatment-related adverse effects and improving quality of life in this patient population. The investigators emphasize that, as biologic therapies continue to evolve, tezepelumab’s efficacy in difficult-to-treat asthma populations represents a key advantage in individualized respiratory care.^1,3

REFERENCES

1. American Medical Journal. Tezepelumab Significantly Improves Severe Asthma Control. News release. October 30, 2025. Accessed November 3, 2025. https://www.emjreviews.com/en-us/amj/respiratory/news/tezepelumab-significantly-improves-severe-asthma-control/

2. Study to Evaluate Efficacy and Safety of Tezepelumab in Reducing Oral Corticosteroid Use in Adult Patients With Severe Asthma (WAYFINDER). ClinicalTrials.gov identifier: NCT05274815. Updat4ed October 23, 2024. Accessed November 3, 2025. https://clinicaltrials.gov/study/NCT05274815

3. Jackson DJ, Lugogo N, Gurnell M, et al. Tezepelumab Reduces and Eliminates OCS Use in OCS-Dependent Patients With Severe Asthma: Primary Results From the Phase 3b WAYFINDER Study. Am J Respir Crit Care Med. 2025;211:A5231. doi:10.1164/ajrccm.2025.211.Abstracts.A5231

4. Tezspire (tezepelumab-ekko). Accessed November 3, 2025. https://www.tezspire.com/