Tezepelumab Helped Severe Asthma Patients Cut Oral Steroids in a 28-Week Trial

For some people with severe asthma, the daily burden is not only wheeze or breathlessness. It is the long-term use of oral corticosteroids, medicines that can calm dangerous inflammation but also carry risks when used for months or years. The SUNRISE phase 3 trial, published in The Lancet Respiratory Medicine in 2026, tested whether tezepelumab could help adults with severe, oral-corticosteroid-dependent asthma reduce that maintenance steroid dose while keeping asthma control.


Tezepelumab is a monoclonal antibody that blocks thymic stromal lymphopoietin, or TSLP. That matters because TSLP is released by airway epithelial cells and sits upstream of several inflammatory pathways involved in asthma. Many asthma biologics focus on narrower downstream signals or patient groups. Tezepelumab’s appeal is that an upstream target might help across a broader severe-asthma population, including people whose biomarker profile does not fit a single simple category.

SUNRISE was designed as a double-blind, placebo-controlled trial across 63 sites in 12 countries. Participants were adults aged 18 to 80 with physician-diagnosed asthma who had been using medium- or high-dose inhaled corticosteroids for at least 12 months and also depended on maintenance oral corticosteroids. After steroid-dose optimization, they were randomly assigned in a 2-to-1 ratio to tezepelumab 210 mg or placebo by subcutaneous injection every four weeks for 28 weeks. The main question was not whether people could simply take less steroid on paper. It was whether they could reach a greater category of oral-corticosteroid reduction at week 28 while maintaining asthma control.

The trial ended early because of recruitment challenges, so its scale is smaller than planned. Of 207 planned participants, 122 received at least one dose: 83 in the tezepelumab group and 39 in the placebo group. Still, the primary result favored tezepelumab. The odds of reaching a greater percentage reduction category in daily maintenance oral corticosteroid dose at week 28 were significantly higher with tezepelumab than with placebo, with an odds ratio of 2.93 and a 95 percent confidence interval from 1.43 to 6.03. Over 28 weeks, at least one asthma exacerbation occurred in 30 percent of the tezepelumab group and 59 percent of the placebo group.


Safety also needs plain language. Adverse events occurred in 57 percent of participants receiving tezepelumab and 72 percent receiving placebo; serious adverse events occurred in 8 percent and 13 percent respectively. Three deaths occurred in the study period or post-treatment period, and investigators did not consider them causally related to the study treatment. That does not make any biologic casual or automatic. It means the reported trial did not identify a new safety concern in this limited group.

The context includes earlier and parallel evidence. WAYFINDER, a single-arm phase 3b study, followed adults with corticosteroid-dependent severe uncontrolled asthma for up to 52 weeks and reported that nearly 90 percent reached a maintenance dose of 5 mg per day or less without loss of asthma control at weeks 28 and 52; about one third discontinued oral corticosteroids at week 28 and about half at week 52. Because WAYFINDER did not include a placebo group, SUNRISE adds a more controlled comparison, while WAYFINDER adds longer and larger practical experience.

The clinical boundary is essential. Oral corticosteroids cannot be stopped abruptly by a reader because adrenal function, exacerbation risk and previous steroid exposure matter. The SUNRISE and WAYFINDER protocols reduced doses under medical rules, with asthma control monitored. The hopeful lesson is therefore specific: blocking TSLP may help some severe-asthma patients reduce steroid burden, but the value is measured by fewer exacerbations, stable control, supervised tapering and long-term safety evidence, not by a simple promise to abandon medication.