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Monthly tezepelumab (Tezspire; AstraZeneca) injections can help people with severe asthma reduce or even stop daily oral corticosteroids (OCS), according to the results of a study.
Publishing the findings of a WAYFINDER study in The Lancet Respiratory Medicine on 26 November 2025, researchers found that half (50%) of the patients who were given tezepelumab as part of the trial were able to stop taking OCS altogether by 52 weeks.
Researchers analysed data from 298 participants in the WAYFINDER trial who received tezepelumab 210mg subcutaneously once every four weeks for up to 52 weeks.
Of those participants, half (50%, n=150) were able to stop taking daily OCS altogether by week 52, while nine out of ten participants (90%, n=268) were able to reduce their daily OCS dose to 5mg or less without loss of asthma control.
The drug is a monoclonal antibody, which inhibits thymic stromal lymphopoietin (TSLP): a cytokine involved in inflammatory responses.
Tezepelumab is recommended by the National Institute for Health and Care Excellence (NICE) for people aged 12 years and older with severe asthma, where treatment with high-dose inhaled corticosteroids (ICS) plus another maintenance treatment is insufficient.
NICE only recommends the drug for patients who have had three or more exacerbations in the previous year, or who are taking maintenance OCS.
The study authors noted that between 3–10% of patients with asthma have severe disease that remains uncontrolled, even when they are using standard treatments such as high-dose ICS and long-acting β2-agonists. Many of these patients take OCS, and at the start of the WAYFINDER trial, participants had a mean baseline maintenance OCS dose of 10.8mg per day, they added.
However, the authors said: “Prolonged OCS use is associated with an increased risk of adverse effects, including osteoporosis, diabetes, ocular disorders, infections, renal impairment and anxiety or depression.”
The WAYFINDER results show that tezepelumab “can enable patients with OCS-dependent severe, uncontrolled asthma to effectively reduce their OCS use and its associated burden”, the authors said.
Darush Attar-Zadeh, clinical fellow respiratory pharmacist at North West London Integrated Care Board, commented: “Severe asthma affects only a small proportion of the patients I see, but for those who rely on daily OCS, the burden is substantial. I would love to see a day when routine OCS use is a thing of the past, given the well-known side effects even at low doses.
“It’s encouraging to see studies like this deepen our understanding of what works for the right patient. As more evidence accumulates — especially around steroid-sparing benefits — there is a strong case for NICE and commissioners to review whether the current access thresholds remain appropriate.”
The charity Asthma + Lung UK estimates that in the UK, around 7.2 million people have asthma — around 4% of which have severe asthma.
Samantha Walker, director of research and innovation at Asthma + Lung UK, said: “This is an incredibly encouraging development for the future of asthma care that could transform the lives of people with severe asthma.
“It’s vital that research into new types of treatment continues but we know current funding for lung health research is on life-support, despite lung conditions remaining the third biggest cause of death in the UK. Studies like this show the positive impact that research can make on providing potentially life-changing treatment for people with asthma and other lung conditions.”
Ellen Forty, research networks and partnership manager at Asthma + Lung UK, said: “It has previously been shown that tezepelumab can decrease the need for oral steroids in people with asthma.
“The implication of this current study is for people with severe asthma who are currently eligible for treatment with tezepelumab, and the new evidence it brings is a tested protocol which doctors can use to guide the safe reduction of oral steroids in these patients as they move onto tezepelumab.”
She added: “The findings provide more evidence about how, for people with severe asthma, biologics can help to shift the dependence away from oral steroids — which we know have concerning side effects for people with asthma who have been using them long term.
“The approach to safely move away from oral steroids and onto a biologic, whilst maintaining symptom control, could also be extended to other biologics in clinical use for people with asthma.”
Read more: Improving the management of uncontrolled asthma for adults in England: where do pharmacists fit?
