Is Tezepelumab effective for severe asthma?

Question

Hello doctor,

I am seeking advice about Tezspire (Tezepelumab) for my 19-year-old son's severe asthma. His pulmonologist recommended it after his fourth hospitalization this year. His pulmonary function tests (PFTs) show that his (FEV1) is only 54 percent of the predicted value, and his blood eosinophil count is 680 cells/μL. Inhaled steroids and Montelukast are no longer effective, and oral Prednisone causes him severe mood swings and insomnia. His last asthma attack was so severe that his oxygen saturation dropped to 84 percent, and he required BiPAP in the emergency room. The allergist has informed us that he is allergic to dust, pollen, cats, cockroaches, and mold. We have made every possible environmental change in our apartment, but nothing seems to help. His pulmonologist mentioned that Tezspire is different because it targets thymic stromal lymphopoietin (TSLP) instead of just eosinophils, but the insurance company is making it difficult to get approval. His quality of life is terrible—he can no longer play soccer, misses classes, and uses his rescue inhaler multiple times a day (his peak flow is usually around 250-300). We have already tried Fasenra with minimal benefit. His immunoglobulin E (IgE) level is 1,246 IU/mL. Do you think Tezspire would be more effective than what we have already tried? The cost is unaffordable without insurance coverage.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Tezspire (Tezepelumab) could be a game-changer for your son because it blocks thymic stromal lymphopoietin (TSLP), a key driver of airway inflammation, rather than just targeting eosinophils or IgE. Unlike Fasenra, which mainly affects eosinophilic asthma, Tezspire works across different asthma types, making it a good option given his severe symptoms and high allergy burden. Studies show it significantly reduces exacerbations and steroid dependence. Since insurance is pushing back, his pulmonologist can submit a prior authorization with documentation of his frequent hospitalizations and Fasenra failure. A patient assistance program from the manufacturer may also help with costs - have you looked into that?

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.