Tezepelumab Improves Functional Exercise Capacity and Asthma Control in Severe Asthma: PEACE-24 Study
Italy: A new study published in Respiratory Medicine has shown that treatment with tezepelumab significantly improved functional exercise capacity and asthma control in patients with severe asthma. After 24 weeks of therapy, patients walked farther during the six-minute walk test, experienced less breathlessness, and reported better physical functioning and quality of life. The improvement in exercise capacity was also associated with better lung function, suggesting that exercise intolerance may be a modifiable feature of severe asthma.
The findings come from the PEACE-24 study, led by Benedetta Bondi, MD, from the Respiratory and Allergy Clinic, IRCCS Azienda Ospedaliera Metropolitana, Genoa, Italy, and colleagues. While previous studies have established the effectiveness of tezepelumab in improving asthma control and reducing exacerbations irrespective of type 2 (T2) inflammatory status, its impact on exercise tolerance has remained largely unexplored.
To investigate this aspect, the researchers evaluated adults with severe asthma receiving tezepelumab at the Respiratory and Allergy Clinic of Genoa Metropolitan Hospital. Participants underwent assessments at the start of treatment and again after 24 weeks. The evaluation included spirometry, fractional exhaled nitric oxide (FeNO) measurement, the six-minute walk test (6MWT), and validated questionnaires assessing asthma control, quality of life, sinonasal symptoms, and patient-reported outcomes, including the Asthma Control Test (ACT), Asthma Quality of Life Questionnaire (AQLQ), Sinonasal Outcome Test-22 (SNOT-22), and Respiratory Allergy Patient Perspective (RAPP). Changes before and after treatment were analyzed using paired statistical tests, while correlations between clinical variables were also examined.
The study revealed the following findings:
- After 24 weeks of tezepelumab treatment, the average six-minute walk distance increased from 409 meters to 478 meters.
- The percentage of predicted walking distance improved from 73% to 82%.
- Breathlessness before exercise decreased significantly, with Borg dyspnea scores falling from 3.55 to 1.47.
- Physical functioning improved, with Asthma Quality of Life Questionnaire (AQLQ) physical activity domain scores increasing from 4.24 to 5.80.
- Greater improvements in FEV1 were significantly associated with longer six-minute walk distances, indicating a positive relationship between better lung function and exercise capacity.
The authors noted that tezepelumab may improve exercise tolerance through multiple mechanisms, including reducing airway inflammation, bronchial hyperresponsiveness, and mucus hypersecretion while enhancing respiratory function. These benefits may extend beyond symptom control to improve patients' ability to perform daily physical activities.
The researchers concluded that tezepelumab significantly enhances functional exercise capacity in patients with severe asthma, alongside improvements in dyspnea and quality of life. They suggested that exercise intolerance should be considered a potentially treatable trait in severe asthma management and highlighted the need for further studies to confirm these findings in larger patient populations.
Reference:
Bondi, B., Braido, F., Pilo, A., Mincarini, M., Di Marco, F., Riccio, A. M., Baiardini, I., Ricchiuto, F., & Bagnasco, D. (2026). The PEACE-24 Study: Tezepelumab Improves Functional Exercise Capacity and Asthma Control in Severe Asthma. Respiratory Medicine, 109009. https://doi.org/10.1016/j.rmed.2026.109009
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