Tezepelumab is effective in older patients with type 2 severe asthma, and baseline serum cytokine levels may be useful in predicting the efficacy of tezepelumab

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Objective Tezepelumab, a monoclonal antibody targeting thymic stromal lymphopoietin (TSLP), is effective in treating severe asthma. However, the factors predicting the therapeutic efficacy of tezepelumab remain unclear. This study examined the background and serum cytokine levels of patients with severe asthma who were treated with tezepelumab to identify the factors that predict therapeutic efficacy.Methods Eighteen patients with severe asthma who received tezepelumab were enrolled in this small cohort. Blood tests, pulmonary function tests, and questionnaires were administered at baseline and after 1, 2, 4, 6, and 12 months of treatment. Responders, i.e., participants with a Global Evaluation of Treatment Effectiveness score of “good” or “excellent” 4 months after treatment initiation, were included in the analysis.Results There were twelve responders and six non-responders. Responders were older than non-responders, and treatment was significantly more effective in patients with type 2 asthma than in those with non-type 2 asthma. At baseline, responders had significantly lower levels of PDGF-BB and ST2/IL-33R than non-responders (PDGF-BB: responders, 7802.4 ± 1658.8 pg/mL, non-responders, 9530.0 ± 1498.5 pg/mL, p = 0.048; ST2/IL-33R: responders, 13732.8 ± 4472.3 pg/mL, non-responders, 22168.5 ± 5699.3 pg/mL, p = 0.003).Conclusions Tezepelumab was more effective in older patients with type 2 asthma than in those with non-type 2 asthma. Furthermore, baseline serum ST2/IL-33R levels, a potential target for new asthma treatments, may be useful in predicting the efficacy of tezepelumab. However, larger studies are needed to validate our findings.

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