Upper and lower airways response to tezepelumab in asthma patients with / without comorbid nasal polyposis: a 6-months reallife perspective

Backgroud: The efficacy of tezepelumab in chronic rhinosinusitis with nasal polyps (CRSwNP) has been demonstrated in clinical trials, but real-world evidence remains limited. Our study investigated the trend of CRSwNP outcomes in patients prescribed with tezepelumab for severe asthma and the impact of upper airways comorbidity on asthma outcomes over a 6 months follow-up. Methods: Data from 5 referral centres for severe asthma and CRSwNP were retrospectively analysed. Patient reported outcomes and objective measures related to nasal (SNOT-22, VAS, nasal polyp score) and bronchial (asthma control test, lung function) evaluation were assessed at baseline, 3 and 6 months after tezepelumab initiation. Results: Tezepelumab significantly and rapidly improved all the nasal outcomes and asthma-related parameters, irrespective of sex, body mass index, prior biologic use, or disease duration. Furthermore, significant reduction of oral corticosteroid use, hospitalizations and exacerbations were also observed. When comparing patients with and without CRSwNP, no differences were observed in term of treatment response. Conclusions: In patients with severe asthma and CRSwNP, tezepelumab demonstrated to induce in the real-life setting an overall rapid and sustained improvement of nasal outcomes, as well as of lung function and clinical parameters in asthma patients regardless of upper airway involvement. Although larger studies are needed, these findings contribute to the positioning of tezepelumab in the real-world clinical practice according to a precision medicine approach.