Summary
Tezepelumab is a biologic for severe asthma that reduces exacerbations by blocking TSLP, a cytokine which drives T2 and non-T2 inflammatory pathways. This benefits more patients than biologics that target T2 alone. My SSC investigated why some patients receiving Tezepelumab still exacerbate, by comparing biomarkers at baseline and during attacks.
Our analysis suggested that T2-inflammation was often suppressed even during exacerbations, indicating that switching to alternative T2-inhibiting biologics may be ineffective in this group. Combination therapies targeting non-T2 pathways alongside Tezepelumab, could be trialled in this population. These findings were submitted in a larger paper to the European Respiratory Society with aims of improving asthma care strategies.
Before my SSC, I thought asthma management was straightforward because I understood the guidelines. Reading stories describing years of escalating therapies that still failed to bring relief changed how I interpret guidelines and new medications. While guidelines are a powerful tool and new therapies might appear to provide answers, both operate at population levels, and the person in front of me may be more complex. I have therefore learned that good practice means not just following evidence-based frameworks but also recognising their limits and supporting patients who don’t fit neatly within them.
Nicola Claire Hood Memorial Award 