Improvement of Severe Volume Dependent Airway Closure With Tezepelumab: A Case Report

Severe asthma may be complicated by airway remodeling, manifesting as higher symptom burden, airflow limitation and reduced treatment response. The effect of biologics on lung function changes remains uncertain. We report a 31-year-old man with severe uncontrolled asthma and chronic rhinosinusitis with nasal polyposis, characterized by frequent exacerbations, marked type 2 inflammation, and pronounced volume-dependent airway closure on spirometry with evidence of small airway dysfunction. Despite optimized high-dose inhaled therapy, disease control remained poor. Treatment with tezepelumab was initiated following multidisciplinary assessment. After 12 months, the patient achieved normalization of symptoms, biomarkers, lung function, and flow-volume loop morphology without any further exacerbations. This case highlights a striking functional recovery associated with thymic stromal lymphopoietin blockade and suggests a potential role for tezepelumab in modifying early airway remodeling beyond symptom control.