Abstract Rationale Tezepelumab, an anti-thymic stromal lymphopoietin (TSLP) monoclonal antibody, has demonstrated broad efficacy in severe asthma across type 2 (T2) phenotypes. However, real-world data on multidomain remission outcomes remain limited. Methods This prospective, multicentre, real-world study included 93 adults with severe asthma treated with tezepelumab (210 mg every 4 weeks) across 14 specialized asthma units in Spain. Patients were followed for 12 months, with assessment of exacerbations, maintenance oral corticosteroid (OCS) use, Asthma Control Test (ACT) scores, lung function, biomarkers, and remission domains. Clinical remission was defined as: (1) strict—no exacerbations, no maintenance OCS, ACT ≥20, and FEV₁ ≥80% predicted; and (2) pragmatic—no exacerbations, no OCS, ACT ≥20, and no FEV₁ decline 5%. Biological remission was defined as FeNO 25 ppb and blood eosinophils 300/μL. Results At 12 months, the annualized exacerbation rate decreased from 3.59 ± 2.45 to 1.14 ± 1.46 (−68%; p 0.001). Maintenance OCS use declined from 41% to 21% (p 0.01), and mean ACT scores improved from 13.6 ± 4.9 to 19.8 ± 4.7 (p 0.001). FEV₁ (% predicted) increased from 70.7% ± 23.5 to 75.6% ± 24.6 (p 0.001). FeNO and eosinophil counts decreased significantly (p = 0.034 and p = 0.004). Among patients with complete data (n = 77), 19 (22.1%) achieved strict and 28 (36.4%) pragmatic clinical remission; biological remission was observed in 73.1%, and complete remission (both clinical and biological) in 22%. Improvements were consistent across T2-high and T2 low phenotypes, with the greatest exacerbation reduction in allergic asthma (−78%). Conclusions In this 1-year, multicentre real-world study, tezepelumab provided sustained, multidomain effectiveness in severe asthma, significantly reducing exacerbations and OCS use while improving symptom control, lung function, and inflammatory biomarkers. Both strict and pragmatic definitions of remission captured clinically meaningful disease control, highlighting tezepelumab’s potential as a broad and durable treatment option for patients with severe asthma in routine practice. This abstract is funded by: None
Sanz et al. (Fri,) studied this question.