Tezepelumab
Biologics for asthma
Biologics for asthma
An antibody against the epithelial alarmin TSLP, an add-on for severe asthma that also helps when eosinophils are not raised.
Quick facts
- Group
- Biologics for asthma
- Target
- Thymic stromal lymphopoietin (TSLP)
- Used for
- Severe asthma
- Key effects
- Injection-site pain · Sore throat · Joint or back pain
- Monitor
- Exacerbations · Allergic reactions after injections
- ATC
- R03DX11
No doses: the clinician sets them by the current guideline.
Mechanism of action
The figure shows human TSLP bound to the Fab fragment of tezepelumab (crystal structure).
Thymic stromal lymphopoietin (TSLP) is an alarmin released by airway epithelial cells, with higher expression in asthma, especially severe asthma. It sits upstream of type 2 inflammation and switches on Th2 and ILC2 cells. Tezepelumab, a human monoclonal antibody, binds TSLP and blocks it from reaching its receptor. Downstream IL-5 and IL-4/IL-13 effects fall (fewer blood eosinophils, lower exhaled nitric oxide), and it also acts in asthma without a type 2 profile.
- Airway epithelium releases TSLP, more so in severe asthma
- Tezepelumab binds TSLP and blocks its receptor
- Type 2 cytokines (IL-5, IL-4, IL-13) and others fall
- Exacerbations fall, with or without high eosinophils
Indications
- Severe asthma, as add-on maintenance from twelve years of age, regardless of phenotype Asthma →
- Chronic rhinosinusitis with nasal polyps Chronic rhinosinusitis and nasal polyps →
Adverse effects
Common
- Injection-site pain, redness or swelling
- Sore throat
- Joint or back pain
Contraindications
- Hypersensitivity to tezepelumab
- Not for an acute asthma attack
- A worm (helminth) infection is treated first
Key interactions
- Live attenuated vaccines
- Avoided during treatment; vaccines are discussed with the doctor first
- Corticosteroids
- Are reduced gradually, if appropriate, not stopped abruptly
What is monitored
- Exacerbations and oral corticosteroid use
- Allergic reactions after injections
- Eye symptoms
Administration and safety
- Subcutaneous injection into the upper arm, thigh or abdomen, by staff or at home with a prefilled pen after training
- Stored in the refrigerator, not frozen or shaken; once kept at room temperature it is not returned to the refrigerator
Pregnancy and breastfeeding
Data in pregnancy are limited; antibodies cross the placenta, and use is decided with the specialist.
Nursing care
- Ask about worm infections and planned vaccinations before starting
- Teach the signs of an allergic reaction
- Remind that it does not treat an attack: the rescue inhaler is still needed
- Teach correct storage of the pen
Pharmacokinetics
- Absorption
- Subcutaneous injection
- Elimination
- Broken down like other antibodies (proteolysis)
Test yourself
Think of the answer, then tap the question to see it.
Which cytokine does tezepelumab block?
Thymic stromal lymphopoietin (TSLP), an epithelial alarmin.
Why can tezepelumab help patients without raised eosinophils?
TSLP sits upstream of several inflammatory pathways, not only type 2.
Which vaccines are avoided during tezepelumab treatment?
Live attenuated vaccines.
Connections
← Back to the class: Biologics for asthma
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Tezepelumab Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); RCSB PDB - 5J13: Structural basis for TSLP antagonism by the therapeutic antibody Tezepelumab (MEDI9929 / AMG-157) (RCSB Protein Data Bank, 2017); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.