Clinical case of integrating tezepelumab in the treatment of non-T2 severe bronchial asthma

Asthma is a heterogeneous disease that affects approximately 339 million people worldwide. In most patients, asthma can be controlled with standard treatments, including inhaled corticosteroids (ICS), long-acting beta-agonists (LABs), long-acting anticholinergics (LACs), and oral leukotriene receptor antagonists. For more severe cases that remain uncontrolled with standard treatment, gene-engineered therapies (GEBTs) are now available. Existing gene-engineered therapies only inhibit specific molecular targets, such as IgE and T-2 inflammatory cytokines, are suitable for a small subset of patients with severe asthma, and are ineffective in non-allergic or non-eosinophilic (non-T2) asthma phenotypes. However, these biological drugs are only suitable for a group of patients with severe T-2 bronchial asthma and are ineffective in non-allergic or non-eosinophilic asthma phenotypes. Heterogeneous response to asthma treatment is directly related to differences in the nature of airway inflammation, immune cell activation, and glucocorticoid sensitivity. Tezepelumab is a first-in-class monoclonal antibody to thymic stromal lymphopoietin (TSLP) that is prescribed for sever asthma, regardless of the endotype of inflammation. In the presented clinical observation, the inclusion of tezepelumab in the treatment of severe non-atopic non-eosinophilic (non-T-2) uncontrolled asthma led to complete control of asthma symptoms, significant improvement in respiratory function, and did not cause adverse events. The data obtained coincided with the results of the studies.

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