Can Tezepelumab help manage uncontrolled asthma?

Question

Hello doctor,

My 16-year-old daughter has severe, uncontrolled asthma that has progressively worsened despite multiple medication changes. She is currently on high-dose Advair, Spiriva, and Montelukast and still needs Albuterol multiple times daily. She has been hospitalized many times in the past year, missing weeks of school. Her pulmonologist wants to start her on Tezspire, but our insurance requires us to try Nucala first, even though her blood eosinophil count is not particularly elevated. The thought of waiting through another failed medication trial while she continues to suffer is unbearable.

Is Tezspire significantly different in how it works? Could it potentially help even if other biologics do not? She is an amazing soccer player but had to quit the team due to her breathing issues. Additionally, the frequent steroid bursts are affecting her mood and weight. Are there any serious side effects with Tezspire that we should be concerned about? Is there any way to appeal the insurance company's decision?

Any advice would be greatly appreciated.

Answer 1

Hello,

Welcome to icliniq.com.

I am sorry to hear about your daughter's struggles. Tezspire (Tezepelumab) and Nucala (Mepolizumab) work differently. Tezepelumab targets a broader range of inflammatory pathways, which may help even if other biologics do not. Common side effects of Tezepelumab include back pain, joint pain, and sore throat. Serious side effects are rare but can include allergic reactions.

You can appeal the insurance decision by requesting an internal review and, if necessary, an external review. Your doctor can provide medical justification for Tezepelumab, highlighting the urgency due to her severe symptoms and frequent hospitalizations.

I hope this information helps, and I wish your daughter a swift recovery.

Thank you.