Tezepelumab treatment in severe asthma with recurrent chronic rhinosinusitis with nasal polyps: Case series

Background: Tezepelumab is a human IgG2 mAb that inhibits thymic stromal lymphopoietin (TSLP) and is approved for treatment of severe asthma. Bronchial asthma, usually a type 2 inflammatory disease, often co-occurs with chronic rhinosinusitis with nasal polyps (CRSwNP). However, tezepelumab has unkn...

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Main Author: Yoshiro Kai, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Journal of Allergy and Clinical Immunology: Global
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772829324001929
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author Yoshiro Kai, MD, PhD
author_facet Yoshiro Kai, MD, PhD
author_sort Yoshiro Kai, MD, PhD
collection DOAJ
description Background: Tezepelumab is a human IgG2 mAb that inhibits thymic stromal lymphopoietin (TSLP) and is approved for treatment of severe asthma. Bronchial asthma, usually a type 2 inflammatory disease, often co-occurs with chronic rhinosinusitis with nasal polyps (CRSwNP). However, tezepelumab has unknown effects on severe asthma with CRSwNP. Patients with CRSwNP are frequently candidates for endoscopic sinus surgery (ESS). CRSwNP is a crucial factor influencing asthma symptoms. However, some patients experience recurrent CRSwNP. Objective: Tezepelumab is not approved for use with CRSwNP, and TSLP is involved in the pathogenesis of CRSwNP. This study presents the cases of 2 patients with severe asthma complicated with recurrent CRSwNP after ESS in whom tezepelumab rapidly improved asthma and sinusitis symptoms. Methods: We evaluated tezepelumab treatment in patients with severe asthma with recurrent CRSwNP based on symptoms, asthma exacerbation, level of type 2 cytokines, and lung function. Results: After they had received a high-dose inhaled corticosteroid and long-acting β2-agonist, the patients’ asthma remained uncontrolled, as defined by a low Asthma Control Test score. However, tezepelumab reduced severe asthma exacerbation, improved lung function, and controlled asthma symptoms. It improved CRSwNP, asthma-related symptoms, and exercise tolerance, and it inhibited type 2 cytokines extensively, indicating its effectiveness in treating CRSwNP. Tezepelumab was efficacious in these patients and improved their symptoms in terms of comorbidities of the upper and lower airways. Conclusion: Tezepelumab was effective in treating asthma complicated with CRSwNP recurrence after ESS. However, further studies are required to identify the general and specific roles of tezepelumab in treating severe asthma and recurrent CRSwNP.
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spelling doaj-art-7445dddfb81d4878b5ab9c8d1ea7c6292025-08-20T03:49:03ZengElsevierJournal of Allergy and Clinical Immunology: Global2772-82932025-05-014210039610.1016/j.jacig.2024.100396Tezepelumab treatment in severe asthma with recurrent chronic rhinosinusitis with nasal polyps: Case seriesYoshiro Kai, MD, PhD0Department of Respiratory Medicine, Minami-Nara General Medical Center, Nara, Japan; Department of Respiratory Medicine, Nara Medical University, Nara, Japan; Corresponding author: Yoshiro Kai, MD, PhD, Department of Respiratory Medicine, Minami-Nara General Medical Center, 8-1 Fukugami, Oyodo-cho, Yoshino-gun, Nara 638-8551, Japan.Background: Tezepelumab is a human IgG2 mAb that inhibits thymic stromal lymphopoietin (TSLP) and is approved for treatment of severe asthma. Bronchial asthma, usually a type 2 inflammatory disease, often co-occurs with chronic rhinosinusitis with nasal polyps (CRSwNP). However, tezepelumab has unknown effects on severe asthma with CRSwNP. Patients with CRSwNP are frequently candidates for endoscopic sinus surgery (ESS). CRSwNP is a crucial factor influencing asthma symptoms. However, some patients experience recurrent CRSwNP. Objective: Tezepelumab is not approved for use with CRSwNP, and TSLP is involved in the pathogenesis of CRSwNP. This study presents the cases of 2 patients with severe asthma complicated with recurrent CRSwNP after ESS in whom tezepelumab rapidly improved asthma and sinusitis symptoms. Methods: We evaluated tezepelumab treatment in patients with severe asthma with recurrent CRSwNP based on symptoms, asthma exacerbation, level of type 2 cytokines, and lung function. Results: After they had received a high-dose inhaled corticosteroid and long-acting β2-agonist, the patients’ asthma remained uncontrolled, as defined by a low Asthma Control Test score. However, tezepelumab reduced severe asthma exacerbation, improved lung function, and controlled asthma symptoms. It improved CRSwNP, asthma-related symptoms, and exercise tolerance, and it inhibited type 2 cytokines extensively, indicating its effectiveness in treating CRSwNP. Tezepelumab was efficacious in these patients and improved their symptoms in terms of comorbidities of the upper and lower airways. Conclusion: Tezepelumab was effective in treating asthma complicated with CRSwNP recurrence after ESS. However, further studies are required to identify the general and specific roles of tezepelumab in treating severe asthma and recurrent CRSwNP.http://www.sciencedirect.com/science/article/pii/S2772829324001929Asthmachronic rhinosinusitis with nasal polypsthymic stromal lymphopoietintezepelumab
spellingShingle Yoshiro Kai, MD, PhD
Tezepelumab treatment in severe asthma with recurrent chronic rhinosinusitis with nasal polyps: Case series
Journal of Allergy and Clinical Immunology: Global
Asthma
chronic rhinosinusitis with nasal polyps
thymic stromal lymphopoietin
tezepelumab
title Tezepelumab treatment in severe asthma with recurrent chronic rhinosinusitis with nasal polyps: Case series
title_full Tezepelumab treatment in severe asthma with recurrent chronic rhinosinusitis with nasal polyps: Case series
title_fullStr Tezepelumab treatment in severe asthma with recurrent chronic rhinosinusitis with nasal polyps: Case series
title_full_unstemmed Tezepelumab treatment in severe asthma with recurrent chronic rhinosinusitis with nasal polyps: Case series
title_short Tezepelumab treatment in severe asthma with recurrent chronic rhinosinusitis with nasal polyps: Case series
title_sort tezepelumab treatment in severe asthma with recurrent chronic rhinosinusitis with nasal polyps case series
topic Asthma
chronic rhinosinusitis with nasal polyps
thymic stromal lymphopoietin
tezepelumab
url http://www.sciencedirect.com/science/article/pii/S2772829324001929
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