Biomarkers and phenotyping: a holistic approach to asthma treatment with tezepelumab

<bold>Background:</bold> Tezepelumab reduced the annualized asthma exacerbation rate (AAER) and improved lung function, symptom control and quality of life (QoL) across biomarker levels in patients with severe, uncontrolled asthma in the PATHWAY (<ext-link>NCT02054130</ext-link>) and NAVIGATOR (<ext-link>NCT03347279</ext-link>) studies. <bold>Objective:</bold> This <italic>post hoc</italic> analysis assessed the relationship between absolute change in biomarker levels from baseline to week 52 and asthma outcomes in PATHWAY and NAVIGATOR patients. <bold>Methods:</bold> The relationships between absolute changes in biomarkers (blood eosinophil counts, fractional exhaled nitric oxide [FeNO] levels and serum immunoglobulin E [IgE] levels) from baseline to week 52 and AAER, pre-bronchodilator (BD) forced expiratory volume in 1 second (FEV₁), Asthma Control Questionnaire-6 score and Asthma Quality of Life Questionnaire score were assessed over 52 weeks using locally estimated scatterplot smoothing regression. <bold>Results:</bold> In tezepelumab recipients, changes in biomarker levels over 52 weeks were not associated with the AAER, whereas changes in FeNO levels and IgE levels correlated with improved pre-BD FEV₁, and improvements in asthma symptoms and QoL, respectively (<bold>Figure</bold>). <bold>Conclusion:</bold> Changes in biomarker levels over 52 weeks were not associated with on-treatment AAER with tezepelumab treatment; however, changes in some biomarkers correlated with improvements in lung function, asthma symptoms and QoL. <fig><object-id>erj;64/suppl_68/PA3559/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>