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The NAVIGATOR trial evaluated tezepelumab, a monoclonal antibody targeting thymic stromal lymphopoietin, in adults and adolescents with severe uncontrolled asthma. Over the study period, tezepelumab produced a substantial reduction in annualized asthma exacerbations compared with placebo and improved measures including lung function. Importantly, benefit was observed across a range of baseline biomarker profiles, including patients with lower eosinophil counts, supporting the idea that upstream treatment of airway inflammation can extend beyond a single biomarker-defined phenotype. For HCPs, the practical implication is that severe asthma assessment should not rely on one laboratory value in isolation. Exacerbation history, oral corticosteroid exposure, inhaler adherence and technique, comorbidities, and type 2 biomarkers all contribute to the decision about advanced therapy. The study is particularly aligned with the conference focus on phenotyping in everyday practice and on the emerging biologics era. It also supports a stepwise approach: confirm the diagnosis, optimize inhaled therapy and technique, address modifiable factors, and then consider biologic therapy for patients who remain uncontrolled and meet appropriate clinical criteria.
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The NAVIGATOR trial evaluated tezepelumab, a monoclonal antibody targeting thymic stromal lymphopoietin, in adults and adolescents with severe uncontrolled asthma. Over the study period, tezepelumab produced a substantial reduction in annualized asthma exacerbations compared with placebo and improved measures including lung function. Importantly, benefit was observed across a range of baseline biomarker profiles, including patients with lower eosinophil counts, supporting the idea that upstream treatment of airway inflammation can extend beyond a single biomarker-defined phenotype. For HCPs, the practical implication is that severe asthma assessment should not rely on one laboratory value in isolation. Exacerbation history, oral corticosteroid exposure, inhaler adherence and technique, comorbidities, and type 2 biomarkers all contribute to the decision about advanced therapy. The study is particularly aligned with the conference focus on phenotyping in everyday practice and on the emerging biologics era. It also supports a stepwise approach: confirm the diagnosis, optimize inhaled therapy and technique, address modifiable factors, and then consider biologic therapy for patients who remain uncontrolled and meet appropriate clinical criteria.
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