Expert review of clinical immunology · 2025
Real-life preliminary evidence for basophils as predictors of Tezepelumab response in severe asthma.
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Quaranta Vitaliano Nicola, Portacci Andrea, Lulaj Ernesto, Dragonieri Silvano, Ferrulli Santina, Sana Flogerta, Buonamico Enrico, Resta Emanuela, Carpagnano Giovanna Elisiana
Аннотация
BACKGROUND: Severe asthma is a complex disease with persistent symptoms despite high-dose inhaled therapy. Tezepelumab, a monoclonal antibody targeting thymic stromal lymphopoietin (TSLP), has shown efficacy across asthma phenotypes. However, identifying early responders remains a challenge. Basophils, key players in type 2 inflammation, may serve as predictive biomarkers.
OBJECTIVE: We evaluated the presence of super-responder status after six months of Tezepelumab therapy and explored the predictive role of blood basophil levels.
METHODS: A real-life, prospective study was conducted on 16 severe asthma patients. Super-responders were defined per Upham et al.'s criteria, adapted for a six-month assessment. Clinical, functional, and inflammatory parameters, including blood basophil counts, were analyzed.
RESULTS: After six months, 62.5% of patients achieved super-responder status, with complete exacerbation elimination, reduced oral corticosteroid use, and improved asthma control. A significant logarithmic association (p = 0.019) was found between baseline basophil levels and super-responder status, indicating that higher basophil counts were associated with an increased likelihood of super-response. This finding was supported by a trend toward significance in ROC curve analysis (AUC = 0.800, p = 0.050), suggesting potential predictive value.
CONCLUSION: Tezepelumab demonstrates early efficacy in severe asthma, and baseline blood basophil levels may represent a promising biomarker for response prediction.
OBJECTIVE: We evaluated the presence of super-responder status after six months of Tezepelumab therapy and explored the predictive role of blood basophil levels.
METHODS: A real-life, prospective study was conducted on 16 severe asthma patients. Super-responders were defined per Upham et al.'s criteria, adapted for a six-month assessment. Clinical, functional, and inflammatory parameters, including blood basophil counts, were analyzed.
RESULTS: After six months, 62.5% of patients achieved super-responder status, with complete exacerbation elimination, reduced oral corticosteroid use, and improved asthma control. A significant logarithmic association (p = 0.019) was found between baseline basophil levels and super-responder status, indicating that higher basophil counts were associated with an increased likelihood of super-response. This finding was supported by a trend toward significance in ROC curve analysis (AUC = 0.800, p = 0.050), suggesting potential predictive value.
CONCLUSION: Tezepelumab demonstrates early efficacy in severe asthma, and baseline blood basophil levels may represent a promising biomarker for response prediction.