Short-term effectiveness of tezepelumab on ENT manifestations in patients undergoing treatment for severe asthma: A pilot real-life study

Purpose: This study aims to assess, for the first time, the efficacy and safety of Tezepelumab in managing ear, nose, and throat manifestations and improving quality of life in asthma patients treated in a real-world setting. Chronic rhinosinusitis is a heterogeneous condition, characterized by various phenotypes that often coexist with comorbidities. While the standard treatment is commonly applied to chronic rhinosinusitis, a significant number of patients do not respond adequately to medical management and experience frequent relapses of nasal polyps. Current biologic therapies primarily target type 2 chronic rhinosinusitis; however, no specific treatments are available for non-type 2 or mixed forms. Tezepelumab, an anti-TSLP monoclonal antibody for severe asthma, emerges as a promising treatment for TSLP-driven diseases. Methods: We conducted a prospective observational study involving 26 patients with severe asthma who also presented sinonasal symptoms. Clinical assessments included nasal endoscopy, nasal congestion scores, SNOT-22, visual analog scale, nasal airflow measurement, olfactory evaluation, and eosinophil count. All 26 patients completed at least 3 months of follow-up. Results: We observed significant improvements in nasal endoscopy scores, nasal congestion scores, SNOT-22, visual analog scale, and olfactory function. Conclusion: These results highlight the potential of Tezepelumab as a versatile therapeutic option for both severe asthma and chronic rhinosinusitis, including phenotypes previously excluded from biologic treatments. However, larger, more homogeneous studies are needed to confirm these findings. We believe that our real-world data may have important implications for the management of chronic rhinosinusitis, regardless of the underlying inflammatory phenotype.