Why have my liver enzymes elevated after taking Tezepelumab?

Question

Hello doctor,

I have been taking Tezepelumab for severe eosinophilic asthma, and now my blood tests show high liver enzymes, and eosinophils are still elevated.

Is that normal while taking this drug?
I have also had three sinus infections since I started. Could this be hypereosinophilic syndrome or a drug reaction?
Should I switch biologics or lower the dose, maybe?

My breathing is better, but I am feeling off overall.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I will require knowing the duration since when you have been taking Tezepelumab. While Tezepelumab is known to produce clinical improvement after a few weeks of therapy (usually 12 weeks), it starts working immediately after the first dose. The eosinophil counts start reducing within the first few weeks and are sustained throughout the therapy. This is also one of the important indicators of the effectiveness of therapy. You are advised to follow up with your treating physician for a clinical evaluation, also in view of your recurrent sinus infections.

Tezepelumab is not known to cause any hepatic or liver damage or toxicity. I would require access to your blood reports and detailed medical history to be able to comment on the significance or the possible cause of high liver enzymes.

I do not have any details of your ongoing treatment to suggest any dose modulation. However, as far as Tezepelumab is concerned, no dose reduction is recommended since it comes as a standard dose (210 mg/1.91 ml) preparation.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.