For patients with severe, uncontrolled asthma, tezepelumab is associated with substantial reductions in asthma exacerbations across asthma phenotypes and underrepresented populations, according to a study published online May 18 in the American Journal of Respiratory and Critical Care Medicine to coincide with the American Thoracic Society 2026 International Conference, held from May 15 to 20 in Orlando, Florida.
Njira Lugogo, M.D., from the University of Michigan in Ann Arbor, and colleagues examined the effectiveness and safety of tezepelumab in a diverse, real-world cohort of 286 U.S. patients (adults and adolescents) with severe, uncontrolled asthma that included different asthma phenotypes and underrepresented populations. Participants received 210 mg tezepelumab subcutaneously every four weeks for 52 weeks.
Of the patients enrolled, 42 percent had a blood eosinophil count ≥300 cells/µL, 58 percent had positive allergy status, 22 percent were Black/African American, 7 percent were adolescents, 20 percent had comorbid chronic obstructive pulmonary disease, and 29 percent were smokers.
The researchers found that the annualized asthma exacerbation rate decreased by 70 percent overall between the baseline and treatment periods and by 54 to 77 percent across asthma phenotypes and underrepresented populations. Clinically meaningful improvements from baseline were seen in 74, 63, and 80 percent of patients in the Asthma Control Questionnaire-6,
Asthma Impairment and Risk Questionnaire, and St. George’s Respiratory Questionnaire scores at week 52 overall, with robust results seen across asthma phenotypes and underrepresented populations (ranges: 64 to 86, 51 to 75, and 63 to 91 percent, respectively). During the treatment period after tezepelumab initiation, 9.8 percent of patients reported a serious adverse event.
“The study results were really reassuring in terms of both safety and efficacy,” Lugogo said in a statement.
The study was sponsored by AstraZeneca, the manufacturer of tezepelumab.
Black Americans continue to experience disproportionately high rates of asthma-related emergency department visits, hospitalizations, and mortality compared with other racial and ethnic groups. One notable aspect of the PASSAGE study is that 22 percent of participants identified as Black/African American — a level of representation that is often lacking in asthma clinical trials. Investigators reported significant reductions in exacerbations among underrepresented populations, suggesting that tezepelumab’s benefits extend beyond the highly selected populations typically enrolled in registration studies.
While biologic therapies are expanding treatment options for severe asthma, many Black patients continue to face barriers that contribute to poor asthma outcomes, including limited access to specialty care, environmental triggers, transportation challenges, medication costs, and inconsistent follow-up.
Clinicians should view therapies such as tezepelumab as one component of a broader asthma management strategy that includes addressing social determinants of health, ensuring access to guideline-directed care, and supporting long-term treatment adherence.
As newer biologics become available to more patients, equitable access will remain critical to reducing persistent asthma disparities.
Many currently available asthma biologics are most effective in patients with elevated eosinophils or other type 2 inflammatory markers. Tezepelumab targets thymic stromal lymphopoietin (TSLP), an upstream driver of airway inflammation, and has demonstrated efficacy across multiple asthma phenotypes, including patients with lower biomarker levels.
For clinicians serving diverse patient populations, this broader applicability may help address treatment gaps among patients who have historically had fewer biologic options.
The findings from the PASSAGE data reinforce several key considerations for practice:
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