Is Tezspire more efficient than other biologics?

Question

Hello doctor,

I am 28 years old and despite being on maximum therapy (Breo, Spiriva, montelukast, theophylline), I still have severe attacks that send me to the ER (emergency room) about twice monthly. I am currently on my 8th round of Prednisone this year which is causing horrible side effects. I gained 36 pounds and my face has got so swollen. I am getting mood swings and it is affecting my relationships. My blood sugar is now in the prediabetic range (fasting 118). My pulmonologist wants to try Tezspire since my previous trials of Fasenra and Dupixent did not provide significant benefit. What is confusing is my numbers do not fit the typical pattern for any specific asthma subtype.

My eosinophil count fluctuates between normal and slightly elevated (currently 380) and my IgE is moderate (290). My worst triggers seem to be respiratory infections, weather changes, and exercise rather than clear allergic reactions. Lung function tests show my FEV1 is only 52% predicted even on good days and drops below 35% during attacks. My insurance initially denied Tezspire saying that I have not failed enough previous therapies despite two hospitalizations requiring ICU (intensive care unit) admission in the past year. I had to take medical leave from my nursing job because I missed so many days and now I am facing possible termination.

Would Tezspire likely work better than the other biologics I tried?
How quickly might I see results if it does help?
Are there any assistance programs that might help cover the cost, if insurance continues to deny coverage?

I am at the end of my rope and terrified of another ICU admission where I might end up intubated. Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I am so sorry you are going through this. Severe asthma that is resistant to treatment can be incredibly frustrating and life-altering. It sounds like you have tried nearly everything, and I understand why you are feeling desperate for relief.

Let us break down your questions about Tezspire (Tezepelumab) and other options.

Would Tezspire work better than other biologics? Unlike Fasenra (Benralizumab) and Dupixent (Dupilumab) which mainly target eosinophilic or allergic asthma, Tezspire works differently. It blocks thymic stromal lymphopoietin (TSLP), an upstream driver of multiple inflammatory pathways. That means it can work for both eosinophilic and non-eosinophilic asthma, which might explain why your doctor is recommending it. Given that your eosinophils fluctuate and your IgE (immunoglobulin E) is not extremely high, it makes sense to try Tezspire since it is not dependent on those markers to be effective.

How quickly might you see results?

Some patients report improvement within the first few weeks, but full effects can take four to six months. Clinical trials showed that Tezspire significantly reduced severe exacerbations and steroid dependency within the first few months. Since you have had frequent ER (emergency room) visits and ICU (intensive care unit) stays, Tezspire has a strong chance of improving your control, but response varies from person to person.

Insurance denial and assistance programs: Since your insurance denied it, you have options like appealing the denial, Tezspire support program, patient assistance foundations, and other considerations.

A Prednisone reduction plan can be used. Long-term steroid use is wreaking havoc on your body (weight gain, swelling, mood swings, blood sugar issues). If Tezspire helps, your doctor may be able to start a slow steroid taper.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.