Rising Use of Tezepelumab Reflects Changing Biologic Therapy Trends in Severe Asthma, Finds Study
USA: Researchers have found in a new study that over the past decade, the initiation of biologic therapy for severe asthma has evolved significantly. Since 2022, the use of tezepelumab has increased rapidly, emphasizing the growing need for alternative treatments for non–T2 asthma. The findings of the study were presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting (Feb 27–Mar 2, 2026, Philadelphia), and subsequently published in the Journal of Allergy and Clinical Immunology.
The study, presented by Isabella Novoa Caicedo from Mayo Clinic and colleagues, examined how prescribing patterns for biologic therapies in severe asthma have shifted in routine clinical practice. Since the first biologic agent for severe asthma was approved in 2003, several additional targeted therapies have entered the market, expanding treatment options and influencing clinician choice. However, real-world data reflecting how these therapies are being adopted over time remains limited.
To address this gap, investigators conducted a retrospective observational analysis using prescription data from 7,015 patients treated within a large U.S. network of specialty allergy and asthma clinics between 2016 and 2025. Adults and adolescents with severe asthma were identified using ICD-10 diagnostic codes. The analysis focused on patients who had received at least one U.S. Food and Drug Administration–approved biologic therapy for asthma. Researchers tracked the first recorded prescription or injection of each biologic during the study period to assess initiation trends.
The key findings were as follows:
- In 2016, only two biologics were available for initiation in severe asthma: omalizumab and mepolizumab.
- Omalizumab accounted for nearly 78% of biologic initiations in 2016, while mepolizumab represented about 22%.
- Initiation rates for both omalizumab and mepolizumab declined substantially over time.
- By 2025, omalizumab initiation had decreased to 19.8%, and mepolizumab to 6.8%.
- Dupilumab comprised 1.2% of biologic initiations in 2017 but increased sharply to 26.7% by 2019, after which its use remained relatively stable.
- Benralizumab accounted for 23.4% of biologic starts in 2018, remained steady through 2023, and declined to 11.3% in 2025.
- Tezepelumab, introduced in 2022, showed consistent growth in initiation rates.
- By 2025, tezepelumab became the most frequently initiated biologic, accounting for 33% of new starts in the cohort.
The researchers concluded that biologic prescribing patterns in severe asthma have undergone significant transformation over the past decade. The rapid uptake of tezepelumab, in particular, highlights increasing clinical demand for therapies that can address non–type 2 inflammatory pathways, broadening treatment possibilities for patients whose disease does not fit the traditional T2-high profile.
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