Abstract Rationale Tezepelumab received US approval in December 2021 as add-on maintenance therapy for patients ≥12 years with severe asthma. Real-world characterization of tezepelumab recipients has been reported from large claims databases. This electronic medical record (EMR) study extends prior work by describing clinical characteristics commonly absent from claims (e.g., lung function and biomarkers) and by quantifying temporal trends in prior recent biologic use since approval. Methods We performed a retrospective cohort study in the TriNetX Dataworks-USA network (de-identified, longitudinal EMR from 71 US healthcare organizations across the US). Eligible patients were ≥12 years old with ≥2 medication orders for tezepelumab between December 17, 2021 and May 17, 2025 and ≥12 months of pre-index history (first order = index). Baseline (12 months pre-index) demographics, comorbidities, asthma characteristics, lung function, and biomarkers were summarized. Biologic-naïve status was defined as no prior orders for an asthma biologic during the 12-months before index; quarterly proportions were calculated. Results A total of 2,270 recipients met the inclusion criteria (mean age 55.7 years SD 16.6; 68.3% female; 70.6% White). Among 77% with available body mass index (BMI), 56.2% had BMI ≥30 kg/m². Common comorbidities included allergic rhinitis (40.2%), gastroesophageal reflux disease (42.0%), hypertension (41.0%), sleep apnea (31.4%), and COPD (28.8%). Among patients with lung function measurements at baseline, the mean percent predicted measures were forced expiratory volume in 1 second (FEV1)=70.6% (n = 111), forced vital capacity (FVC)=79.7% (n = 109), FEV1/FVC= 62.5% (n = 194). Among patients with a blood eosinophil count (BEC) in the baseline period (n = 1,317), 28.5% had an BEC ≥300 cells/µL. Of 398 patients with serum immunoglobulin E (IgE) level in the baseline period, 45.7% had an IgE ≥100 IU/mL. In Q1 2022, 56.4% of initiators were biologic-naïve; this proportion steadily increased each quarter, reaching 78.3% in Q2 2025. Conclusions In this EMR cohort, as expected tezepelumab recipients frequently were obese had comorbidities and reduced lung function. The fraction of patients who were biologic-naïve steadily increased over time after approval, consistent with broadening first-line use. This abstract is funded by: Amgen and AstraZeneca
Lindsley et al. (Fri,) studied this question.