How to manage Asthma with Tezspire Initiation Therapy?

Question

Hello doctor,

I am a 29-year-old female with severe asthma and multiple phenotypes. I need advice on Tezspire (Tezepelumab) initiation. My blood eosinophil counts 450, and fractional exhaled nitric oxide (FeNO) is 65 parts per billion (ppb). I have a history of anaphylaxis to Omalizumab and failed Dupixent (Dupilumab). The current asthma control test (ACT) score is 14 despite optimal inhaler technique. Frequent oral corticosteroid (OCS) bursts affect bone density. Any data on cross-reactivity? Loading dose protocols?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

To better understand your situation and provide personalized guidance on Tezspire (Tezepelumab) initiation, I need more details about your clinical history and pulmonary function tests (PFTs).

Please provide the following information:

Clinical history:

Asthma duration: How long have you had asthma?
Previous treatments: List all asthma medications, biologics, and oral corticosteroids (OCS) you have used, including dosages and durations.
Hospitalizations and intensive care unit (ICU) admissions: Have you been hospitalized or admitted to the ICU for asthma exacerbations?
Comorbidities: Do you have any other medical conditions, such as allergies, eczema, or gastroesophageal reflux disease (GERD)?

Pulmonary function tests (PFTs):
1. Most recent PFT results: Provide your latest forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio values.
2. PFT trends: Have your PFT results been stable, improving, or declining over time?
3. Bronchodilator response: Have you had a bronchodilator response test, and if so, what were the results?
  
  Additional Information
  1. Current medications: List all your current medications, including inhalers, biologics, OCS, and other treatments.
  2. Allergies: Do you have any known allergies, especially to medications or biologics?
    
    Tezspire (injection) (Tezepelumab) (human monoclonal IgG2λ thymic stromal lymphoprotein (TSLP) blocking antibody) is a promising option for severe asthma.
    
    Given your history of anaphylaxis to Omalizumab (monoclonal antibody) and failure with Dupixent (Dupilumab)(interleukin inhibitor), it is essential to discuss cross-reactivity. However, there is not much data available on cross-reactivity between Tezspire (Tezepelumab) and other biologics.
    
    Regarding loading dose protocols, Tezspire (Tezepelumab) is typically administered via subcutaneous injection every four weeks, with no loading dose required.
    
    Kindly consult a specialist doctor, talk with them, and take medications with their consent.
    
    I hope this helps.
    
    Thank you.