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Tezepelumab (Tezspire; AstraZeneca) reduced the need for long-term oral corticosteroid use in a study of adults with severe asthma, researchers have reported in The Lancet Respiratory Medicine.
The ‘SUNRISE’ trial tested the monoclonal antibody — given as a monthly subcutaneous injection — in adults with severe asthma who were dependent on medium or high-dose inhaled corticosteroids. The trial took place between August 2022 and March 2025.
Tezepelumab interferes with thymic stromal lymphopoietin (TSLP) binding, and so reducing the production of inflammatory biomarkers and cytokines.
A total of 122 patients began the study, with 83 participants receiving tezepelumab at 210mg monthly, and 39 patients receiving placebo, with cohorts followed for 28 weeks. Of the initial 122 patients, 90 completed the study.
During the trial, 69% (n=57) of patients receiving tezepelumab were able to reduce oral corticosteroid dose by at least 50%, compared with 44% (n=17) of patients receiving placebo.
In addition, 35% (n=29) of patients treated with tezepelumab stopped all use of oral corticosteroids, compared with 21% (n=8) in the placebo group.
Over the 28-week trial period, 30% (n=25) of participants in the tezepelumab group experienced at least one asthma exacerbation, compared with 59% (n=23) of participants in the placebo group.
The authors wrote: “Despite the smaller than planned sample size, the results of the SUNRISE trial show the potential of tezepelumab to reduce maintenance oral corticosteroid use while maintaining asthma control and without compromising the efficacy outcomes.”
Lead author Michael Wechsler, director of the Cohen Family Asthma Institute at National Jewish Health, said: “These findings are important because they show that patients with severe asthma treated with tezepelumab may be able to substantially reduce their dependence on oral steroids without sacrificing asthma control.”
The SUNRISE findings are similar to those found in the larger ‘WAYFINDER’ study, in which half (n=150) of patients taking tezepelumab were able to stop taking oral corticosteroids altogether by 52 weeks.
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 has only recommended the drug for patients who have had three or more exacerbations in the previous year, or who are taking maintenance oral corticosteroids.
Darush Attar-Zadeh, honorary clinical fellow respiratory pharmacist at North West London Integrated Care Board, commented: “This is a double-blinded study, which adds another huge layer of evidence to support the previous WAYFINDER finding.
“What’s also pleasing to see is that in the cohort of patients that were on tezepelumab, it not only reduced the annualised asthma exacerbation rates but also resulted in clinically meaningful improvements in lung function and asthma symptom control, despite a reduction in the daily maintenance oral corticosteroids.
“There are of course some limitations [such as] with sample sizes, especially in the low type 2 asthma cohort, and it would be good to see some further research here.”
Erika Kennington, head of research and innovation at charity Asthma + Lung UK, commented: “These trial results are an encouraging step forward for the future of asthma care. They show that people with severe asthma may be able to reduce their daily steroid dose, whilst also keeping their condition stable — something that is really important to patients.
“Given the harms linked to long-term steroid use, this could mark a shift in how we treat severe asthma and also mean a greater choice of treatments available, which is important as not every treatment works for every person.”
