Effects of Tezepelumab in “United Airway Disease” (Asthma and CRSwNP)

Severe asthma is a heterogeneous disease typically characterized by inadequate symptom control, even with frequent oral corticosteroids, large doses of inhaled corticosteroids, and long-acting β2-adrenergic agonists. The latest Global Initiative for Asthma (GINA) recommendations suggest adding biological therapies at Step 5 to optimize standard treatments. Although there is a wide range of therapeutic options for T2-high asthma, unfortunately, for T2-low asthma, we still have limited therapeutic choices. Our case report refers to a 64-year-old woman with severe T2-low asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) who had already tested other standard therapies without clinical or functional benefits. She is being treated with tezepelumab (210 mg subcutaneous injection, administered every 4 weeks), an antithymic stromal lymphopoietin (TSLP) human monoclonal antibody. After the third dose, she showed significant clinical and functional benefits, which were also confirmed after 6 months of add-on biological therapy with anti-TSLP. In conclusion, this case study suggests that tezepelumab can provide rapid and effective therapeutic action in patients with severe T2-low asthma and nasal polyposis.