Trial finds monthly tezepelumab can replace daily steroids for people with severe asthma

A clinical trial has shown that a monthly injection could allow people living with severe asthma to stop taking daily steroid tablets. The findings offer a significant development for patients who cannot control their symptoms with inhalers alone and rely on oral corticosteroids, which can cause serious long-term health problems when taken regularly.

Asthma affects an estimated 260 million people across the world. Most manage the condition by using inhalers that ease immediate symptoms and others that help reduce inflammation. However, a smaller group of patients has severe asthma that remains uncontrolled, even with those treatments. Many of them take daily doses of oral corticosteroids to manage their condition, despite the recognised risks of ongoing use. Doctors have long warned that these tablets can raise the likelihood of osteoporosis, diabetes and greater vulnerability to infections.

Researchers have now reported encouraging results from an international clinical trial involving almost 300 adults with severe asthma that did not respond to standard medication. The Wayfinder trial, led by King’s College London, examined whether tezepelumab, a treatment already approved for certain patients, could replace daily steroid tablets. Tezepelumab is a medicine that binds to and blocks a protein linked with airway inflammation. It is also known by the brand name Tezspire and is manufactured by AstraZeneca.

Participants in the trial came from 11 countries, including the United Kingdom, the United States, France, Germany, Mexico and Spain. All were taking between 5 milligrams and 40 milligrams of steroid tablets each day when the trial began. They received injections of tezepelumab every four weeks and were monitored as doctors gradually reduced their steroid doses. The results showed that many patients were able to cut back significantly on their tablets, and some were able to stop taking them entirely without any negative effects.

The National Institute for Health and Care Excellence approved tezepelumab in 2023 as an additional maintenance treatment for patients aged 12 and over whose asthma is not well controlled by existing medication. The new findings build on that decision and suggest that the treatment may help reduce dependence on steroids for people whose condition remains severe.

Researchers involved in the trial said the results demonstrate the potential of targeting specific pathways linked with inflammation. They noted that severe asthma presents complex challenges and that many patients live with the long-term impacts of high-dose steroids. The study offers an alternative that may avoid those risks while still keeping symptoms under control.

The trial team also observed that participants tolerated the injections well and did not experience ill effects while reducing or stopping their steroids. The findings suggest that monthly treatment could provide a simpler option for people whose asthma has resisted other approaches. Specialist teams will continue to analyse the data as they consider how the treatment could best be used in clinical practice.

The results come at a time when clinicians are continuing to explore new ways to treat severe asthma with greater precision. The use of targeted therapies has increased in recent years as researchers uncover more details about the mechanisms behind inflammation. Tezepelumab adds another option to the list of treatments aimed at these biological processes.

The study’s authors said the findings underscore the importance of continued research in this area. Many patients still live with symptoms that limit their quality of life, and long-term steroid use remains a significant concern. The Wayfinder trial suggests that a monthly injection could offer a safer and more manageable alternative for people with the most severe forms of the condition.