Effectiveness of Tezepelumab in Patients with Difficult-To-Treat Severe Asthma: Early Insights from the Tezepelumab Patient Access Programme
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Authors
Patel P.
Rupani H.
Pfeffer P.
Mansur A.
Lipworth J.
Lupton C.
Watt M.
Clewes C.
Bailey T.
RajkovicHooley O.
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Issue Date
2024
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Conference Proceedings
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Introduction and Objectives Tezepelumab is indicated in people >=12 years with severe asthma (SA) inadequately controlled despite high dose inhaled corticosteroids plus another maintenance treatment. Clinical trials demonstrated favourable efficacy and safety among patients with SA, irrespective of biomarkers. Real-world evidence for tezepelumab is necessary to demonstrate effectiveness outside of trials. The Tezepelumab Patient Access Programme (TPAP) study aims to evaluate characteristics, treatment patterns and outcomes of adult patients with SA in the real-world. Methods A retrospective, observational, multi-centre chart review is ongoing in six UK SA centres. Patients with SA who participated in the patient access programme with an index date (first dose of tezepelumab) between 1stJanuary 2023 and 19th July 2023 were included. Data were extracted from patients' medical records. This interim analysis (n=46) describes patient's characteristics and annualised asthma exacerbation rates (AAER) in the baseline (12 months prior to index), at index, and in the 12 months post-index. Results Baseline demographics and clinical characteristics are described in table 1. Median (interquartile range IQR]) FeNO closest to index was 15.5 (12.0-21.0) ppb, eosinophil count was 100.0 (0.0-200.0) cells/muL. 32.6% (15/46) had failed another biologic in the preceding 12 months. At index, 69.6% (32/46) were on maintenance oral corticosteroid (mOCS), median (IQR) daily dose 11.8 (8.8, 20.0) mg. In these patients (n=32), median (IQR) mOCS dose had reduced to 6.5 (3.0-17.5) mg at 12 months post-index. Overall 52.2% (24/46) had ongoing mOCS. Mean (SD) AAER was 4.0 (2.4) during baseline, and 2.2 (3.3) in the 12 months post-index (45% relative rate reduction). 59.1% (26/44) had >=50% reduction in AAER or mOCS dose. 86.7% (39/45) remained on tezepelumab. Conclusions This early interim analysis demonstrates that the initial cohort of UK patients who commenced on tezepelumab were a difficult to treat, biomarker low cohort with high burden of mOCS and comorbidities, often ineligible for other biological therapies. Despite this, 59.1% had >=50% reduction in AAER or mOCS dose, and a 45% reduction in AAER was observed. A limitation here is the low sample size; the final analysis will include >180 patients from 8 centres. (Table Presented).
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Thorax