To evaluate the efficacy of tezepelumab in reducing maintenance oral corticosteroid doses in adult patients with severe oral corticosteroid-dependent asthma while maintaining asthma control.
Approach:
Study Design: Phase 3 SUNRISE trial with 122 adults aged 18 to 80 years, randomly assigned to receive either tezepelumab 210 mg or placebo every 4 weeks for 28 weeks.
Participants: Eligible participants were on medium- or high-dose inhaled corticosteroids and long-acting beta-2 agonists, with specific blood eosinophil counts.
Endpoints: Primary endpoint assessed the reduction in daily maintenance oral corticosteroid dose by week 28 without loss of asthma control.
Key Findings:
At week 28, 36% of tezepelumab patients achieved a 90-100% reduction in oral corticosteroid dose vs 21% in placebo.
69% of tezepelumab patients achieved at least a 50% reduction vs 44% in placebo.
Complete discontinuation occurred in 35% vs 21%, respectively.
An oral corticosteroid dose of 5 mg or less was reached in 59% vs 38%, respectively.
Interpretation:
The results of the SUNRISE trial show the potential of tezepelumab to reduce maintenance oral corticosteroid use while maintaining asthma control.
Limitations:
Study terminated early due to recruitment challenges, resulting in a smaller sample size.
Baseline imbalances in blood eosinophil counts and oral corticosteroid doses between treatment groups.
Not powered to assess statistical significance within subgroups.
Conclusion:
The SUNRISE trial indicates the potential of tezepelumab to reduce maintenance oral corticosteroid use while maintaining asthma control.
