TEZSPIRE demonstrated a statistically
significant and clinically meaningful reduction in nasal polyp size
and reduced nasal congestion compared to placebo
Positive high-level results from the Phase III WAYPOINT trial in
patients with chronic rhinosinusitis with nasal polyps (CRSwNP
[nasal polyps]) showed that AstraZeneca and Amgen’s TEZSPIRE®
(tezepelumab) demonstrated a statistically significant and
clinically meaningful reduction in the size of nasal polyps and
reduced nasal congestion compared to placebo.
WAYPOINT is a randomized, double-blind trial that evaluated the
efficacy and safety of TEZSPIRE administered subcutaneously
compared to placebo in adults with severe CRSwNP. Participants in
the trial were symptomatic despite treatment with standard of care
(intranasal corticosteroids [INCS]).1
Dr. Joseph Han, Vice Chair of Rhinology & Endoscopic Sinus
and Skull Base Surgery, and Allergy, Otolaryngology-Head and Neck
Surgery, Eastern Virginia Medical School, US, and co-primary
investigator in the trial, said: “Chronic rhinosinusitis with nasal
polyps negatively impact patients’ daily lives with obstructions
leading to disturbances in smell, taste and sleep as well as pain
and fatigue. The impressive data from the WAYPOINT trial
demonstrate tezepelumab’s potential as a new treatment for patients
whose lives are disrupted by this debilitating disease.”
Dr. Brian Lipworth, Professor of Allergy and Pulmonology,
Scottish Centre for Respiratory Research, and Tayside Rhinology
Ear, Nose and Throat Clinic, Ninewells Hospital University of
Dundee in Scotland, UK, and co-primary investigator in the trial,
said: “Patients diagnosed with nasal polyps continue to experience
significant burden including repeat surgeries and frequent
treatment with high doses of oral corticosteroids, which are
associated with serious systemic side effects. The tezepelumab data
are clinically meaningful and offer patients with nasal polyps hope
for a potential new treatment option that may reduce the burden on
patients and healthcare systems.”
Sharon Barr, Executive Vice President, BioPharmaceuticals
R&D said: “We are excited by the positive results from the
Phase III WAYPOINT trial, which show that patients with nasal
polyps strongly benefitted from treatment with tezepelumab. These
results reinforce that tezepelumab’s first-in-class mode of action,
targeting TSLP at the top of the inflammatory cascade, effectively
addresses the multiple drivers of epithelial-driven inflammatory
diseases.”
The safety profile and tolerability of TEZSPIRE in this trial
were consistent with the known profile of the medicine.
Full results will be shared with regulatory authorities and the
scientific community at an upcoming medical meeting.
TEZSPIRE is currently approved for the treatment of severe
asthma in the US, EU, Japan, and nearly 60 countries across the
globe.2-5 It is approved as a single-use pre-filled syringe and
auto-injector for self-administration in the US and EU.2,3
INDICATIONS AND LIMITATIONS OF USE / ISI
TEZSPIRE® (tezepelumab-ekko)
INDICATION
TEZSPIRE is indicated for the add-on maintenance treatment of
adult and pediatric patients aged 12 years and older with severe
asthma.
TEZSPIRE is not indicated for the relief of acute bronchospasm
or status asthmaticus.
CONTRAINDICATIONS
Known hypersensitivity to tezepelumab-ekko or excipients.
WARNINGS AND PRECAUTIONS
Hypersensitivity Reactions
Hypersensitivity reactions were observed in the clinical trials
(eg, rash and allergic conjunctivitis) following the administration
of TEZSPIRE. Postmarketing cases of anaphylaxis have been reported.
These reactions can occur within hours of administration, but in
some instances have a delayed onset (ie, days). In the event of a
hypersensitivity reaction, consider the benefits and risks for the
individual patient to determine whether to continue or discontinue
treatment with TEZSPIRE.
Acute Asthma Symptoms or Deteriorating Disease
TEZSPIRE should not be used to treat acute asthma symptoms,
acute exacerbations, acute bronchospasm, or status asthmaticus.
Abrupt Reduction of Corticosteroid Dosage
Do not discontinue systemic or inhaled corticosteroids abruptly
upon initiation of therapy with TEZSPIRE. Reductions in
corticosteroid dose, if appropriate, should be gradual and
performed under the direct supervision of a physician. Reduction in
corticosteroid dose may be associated with systemic withdrawal
symptoms and/or unmask conditions previously suppressed by systemic
corticosteroid therapy.
Parasitic (Helminth) Infection
It is unknown if TEZSPIRE will influence a patient’s response
against helminth infections. Treat patients with pre-existing
helminth infections before initiating therapy with TEZSPIRE. If
patients become infected while receiving TEZSPIRE and do not
respond to anti-helminth treatment, discontinue TEZSPIRE until
infection resolves.
Live Attenuated Vaccines
The concomitant use of TEZSPIRE and live attenuated vaccines has
not been evaluated. The use of live attenuated vaccines should be
avoided in patients receiving TEZSPIRE.
ADVERSE REACTIONS
The most common adverse reactions (incidence ≥3%) are
pharyngitis, arthralgia, and back pain.
USE IN SPECIFIC POPULATIONS
There are no available data on TEZSPIRE use in pregnant women to
evaluate for any drug-associated risk of major birth defects,
miscarriage, or other adverse maternal or fetal outcomes. Placental
transfer of monoclonal antibodies such as tezepelumab-ekko is
greater during the third trimester of pregnancy; therefore,
potential effects on a fetus are likely to be greater during the
third trimester of pregnancy.
Please see full Prescribing Information,
including Patient Information and Instructions
for Use.
You may report side effects related to AstraZeneca products.
Notes
Chronic Rhinosinusitis with Nasal Polyps (CRSwNP (nasal
polyps))
CRSwNP is a complex inflammatory disorder, characterized by
persistent inflammation of the nasal mucosa accompanied by benign
growths, called nasal polyps.6,7 Nasal polyps can block nasal
passages and lead to breathing problems, difficulty in sense of
smell, nasal discharge, facial pain, sleep disturbance and other
adverse effects on quality of life.8-10
Epithelial dysfunction and inflammation are important
characteristics of chronic rhinosinusitis and impede the ability of
the epithelium to act as a physical and immunological barrier
against the external environment.11 Thymic stromal lymphopoietin
(TSLP) is an epithelial cytokine that has been implicated in shared
pathophysiological processes underlying severe asthma and
CRSwNP.10,12
Current treatments for CRSwNP include intranasal and/or systemic
corticosteroids, surgery and biologics.8,13-16
Phase III WAYPOINT trial
WAYPOINT is a double-blind, multi-centre, randomized,
placebo-controlled, parallel group trial designed to evaluate the
efficacy and safety of tezepelumab in adults with severe CRSwNP.1
Participants received tezepelumab or placebo, administered via
subcutaneous injection. The trial also included a post-treatment
follow-up period of 12-24 weeks for participants who completed the
52-week treatment period.1
The co-primary endpoints of the trial, were change from baseline
in total nasal polyp size, measured by the endoscopic total Nasal
Polyp Score, and change from baseline in bi-weekly mean nasal
congestion, measured by the participant reported Nasal Congestion
Score evaluated as part of the daily Nasal Polyposis Symptom
Diary.1 Key secondary endpoints included loss of smell; improvement
in disease specific health-related quality of life as measured by
SinoNasal Outcome Test (SNOT-22) score; Lund-Mackay score; time to
surgery decision and/or systemic corticosteroids for nasal
polyposis; time to nasal polyposis surgery decision; time to
systemic corticosteroids for nasal polyposis; Nasal Polyposis
Symptom Diary total symptom score and, in the population with
co-morbid asthma, pre-bronchodilator FEV1 at Week 52.
TEZSPIRE
TEZSPIRE (tezepelumab) is being developed by AstraZeneca in
collaboration with Amgen as a first-in-class human monoclonal
antibody that inhibits the action of TSLP, a key epithelial
cytokine that sits at the top of multiple inflammatory cascades and
is critical in the initiation and persistence of allergic,
eosinophilic and other types of airway inflammation associated with
severe asthma, including airway hyperresponsiveness.17,18 TEZSPIRE
is approved in the US, EU, Japan and other countries for the
treatment of severe asthma.19-21
Amgen collaboration
In 2020, Amgen and AstraZeneca updated a 2012 collaboration
agreement for TEZSPIRE. Both companies will continue to share costs
and profits equally after payment by AstraZeneca of a mid
single-digit inventor royalty to Amgen. AstraZeneca continues to
lead development and Amgen continues to lead manufacturing. All
aspects of the collaboration are under the oversight of joint
governing bodies. Under the amended agreement, Amgen and
AstraZeneca will jointly commercialize TEZSPIRE in North America.
Amgen will record product sales in the US, with AZ recording its
share of US profits as Collaboration Revenue. Outside of the US,
AstraZeneca will record product sales, with Amgen recording profit
share as Other/Collaboration revenue.
AstraZeneca in Respiratory & Immunology
Respiratory & Immunology, part of AstraZeneca
BioPharmaceuticals, is a key disease area and growth driver to the
Company.
AstraZeneca is an established leader in respiratory care with a
50-year heritage and a growing portfolio of medicines in
immune-mediated diseases. The Company is committed to addressing
the vast unmet needs of these chronic, often debilitating, diseases
with a pipeline and portfolio of inhaled medicines, biologics and
new modalities aimed at previously unreachable biologic targets.
Our ambition is to deliver life-changing medicines that help
eliminate COPD as a leading cause of death, eliminate asthma
attacks and achieve clinical remission in immune-mediated
diseases.
AstraZeneca
AstraZeneca is a global, science-led biopharmaceutical company
that focuses on the discovery, development, and commercialization
of prescription medicines in Oncology, Rare Diseases, and
BioPharmaceuticals, including Cardiovascular, Renal &
Metabolism, and Respiratory & Immunology. Based in Cambridge,
UK, AstraZeneca’s innovative medicines are sold in more than 125
countries and used by millions of patients worldwide. Please visit
www.astrazeneca-us.com and follow us on social media
@AstraZeneca.
References
- Clinicaltrials.gov. Efficacy and Safety of Tezepelumab in
Participants With Severe Chronic Rhinosinusitis With Nasal
Polyposis (WAYPOINT). Available at:
https://clinicaltrials.gov/ct2/show/NCT04851964. [Last accessed:
November 2024].
- Tezspire (tezepelumab) US prescribing information. Available
at:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/761224s003lbl.pdf.
[Last accessed: November 2024].
- Tezspire (tezepelumab) Summary of Product Characteristics.
Available at:
https://www.ema.europa.eu/en/documents/product-information/tezspire-epar-product-information_en.pdf.
[Last accessed: November 2024].
- AstraZeneca plc. Tezspire approved in Japan for the treatment
of severe asthma. Available at:
https://www.astrazeneca.com/media-centre/press-releases/2022/tezspire-approved-in-japan-for-severe-asthma.html
[Last accessed: November 2024].
- Data on File. AstraZeneca. 2024. REF-251231.
- Bachert C, et al. Phenotypes and Emerging Endotypes of Chronic
Rhinosinusitis. J Allergy Clin Immunol Pract. 2016; 4 (4):
621-628.
- Del Toro E, Portela J. Nasal Polyps. [Updated 2023 Jul 31]. In:
StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing;
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November 2024].
- Stevens WW, et al. Chronic Rhinosinusitis with Nasal Polyps. J
Allergy Clin Immunol Pract. 2016; 4 (4): 565-572.
- Abdalla S, et al. Prevalence of sinonasal outcome test
(SNOT-22) symptoms in patients undergoing surgery for chronic
rhinosinusitis in the England and Wales National prospective audit.
Clin Otolaryngol. 2012; 37 (4): 276-282.
- Laidlaw TM, et al. Chronic Rhinosinusitis with nasal polyps and
asthma. J Allergy Clin Immunol Pract 2021;9:1133–1141.
- Wynne M, et al. Contribution of epithelial cell dysfunction to
the pathogenesis of chronic rhinosinusitis with nasal polyps. Am J
Rhinol Allergy. 2019;33:782–790.
- Liao B, et al. Interaction of thymic stromal lymphopoietin,
IL-33, and their receptors in epithelial cells in eosinophilic
chronic rhinosinusitis with nasal polyps. Allergy.
2015;70:1169–1180.
- Xolair (omalizumab) Summary of Product Characteristics;
Available at:
https://www.ema.europa.eu/en/documents/product-information/xolair-epar-product-information_en.pdf
[Last accessed November 2024].
- Xolair (omalizumab) US prescribing information; Available at:
https://www.gene.com/download/pdf/xolair_prescribing.pdf [Last
accessed: November 2024].
- Nucala (mepolizumab) US prescribing information; Available at:
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[Last accessed November 2024].
- Dupixent (dupilumab) US prescribing information; Available at:
https://www.regeneron.com/downloads/dupixent_fpi.pdf. [Last
accessed: November 2024].
- Corren J, et al. Tezepelumab in adults with uncontrolled asthma
. N Engl J Med. 2017;377:936-946.
- Varricchi G, et al. Thymic Stromal Lymphopoietin Isoforms,
Inflammatory Disorders, and Cancer. Front Immunol.
2018;9:1595.
- AstraZeneca plc. Tezspire (tezepelumab) approved in the US for
severe asthma. Available at:
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[Last accessed: November 2024].
- AstraZeneca plc. Tezspire approved in the EU for the treatment
of severe asthma. 2022. Available at:
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[Last accessed: November 2024].
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[Last accessed: November 2024].
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