Real-world effectiveness of tezepelumab for patients with severe asthma in the United States: CROSSROADS-3

Tezepelumab was approved in the United States in December 2021 for patients aged 12 years and older with severe asthma. Efficacy has been exhibited in clinical trials, but real-world evidence of its impact on severe asthma management is more limited.

To describe US patients receiving tezepelumab and to assess real-world treatment patterns and outcomes before and after initiation of tezepelumab.

This retrospective, single-arm, self-controlled, observational study analyzed US patients aged 12 years and older with severe asthma who initiated tezepelumab between December 2021 and August 2022 using insurance claims data. The overall cohort included patients with at least 2 asthma exacerbations in the 12 months before initiating tezepelumab. Annualized asthma exacerbation rates, cumulative oral corticosteroid use, and exacerbation-related health care resource utilization were compared in the 12 months before and after tezepelumab initiation.

Among tezepelumab recipients (n = 321), 45% had received another biologic in the 12 months before; among those with available data (n = 143), 68% had a blood eosinophil count of less than 300 cells/µL. The annualized asthma exacerbation rates were reduced by 58% (95% CI, 53%-62%) after tezepelumab initiation. The average annual cumulative oral corticosteroid dose (prednisone-equivalent) was reduced from 1295 mg to 770 mg (P < .001). Asthma exacerbation-related inpatient, emergency department, and outpatient visits also decreased. Reductions in asthma-related outcomes were seen in both biologic-naive and biologic-experienced cohorts and across multiple clinical subgroups of interest.

Patients with severe asthma treated with tezepelumab in the first 9 months after US approval experienced meaningful clinical benefits.