A single monthly injection could help severe asthma sufferers break free from daily steroid pills.
For decades, many people living with severe asthma have depended on daily oral corticosteroids (OCS) just to keep their symptoms under control—often at the cost of serious side effects. But new research suggests that a monthly injection of tezepelumab (Tezspire; AstraZeneca) could change that. According to the recently published WAYFINDER study in The Lancet Respiratory Medicine (26 November 2025), researchers found that half of the patients who received tezepelumab were able to completely stop taking daily OCS within a year.
The trial included 298 participants diagnosed with severe, uncontrolled asthma. Each participant received 210mg of tezepelumab via a subcutaneous injection every four weeks for up to 52 weeks. After that period, nearly 50% (n=150) managed to discontinue their oral corticosteroid use entirely. Even more impressively, 90% (n=268) were able to cut their OCS dose to 5mg or less while still maintaining stable asthma control.
Tezepelumab is a monoclonal antibody designed to block thymic stromal lymphopoietin (TSLP)—a key cytokine that triggers the chain reactions responsible for airway inflammation. In simpler terms, it aims to calm the immune overreaction at the root of severe asthma, rather than just treating symptoms after they appear.
Currently, the National Institute for Health and Care Excellence (NICE) recommends tezepelumab for people aged 12 and older who have severe asthma not adequately controlled by high-dose inhaled corticosteroids (ICS) plus another maintenance therapy. However, NICE limits its use to patients who have experienced at least three asthma flare-ups in the past year or require long-term OCS treatment. Some experts argue these eligibility criteria may now need reevaluation, given the growing evidence of tezepelumab’s steroid-sparing potential.
The study highlights an important fact often overlooked: between 3% and 10% of asthma patients have severe forms of the disease resistant to standard therapies such as high-dose ICS or long-acting β₂-agonists. Many rely on daily OCS just to breathe comfortably. At the start of the study, participants averaged 10.8mg of OCS per day — a reminder of how heavily dependent some patients have become on these medications.
Yet, long-term steroid use comes with a high price. The researchers emphasized that prolonged exposure to OCS increases the likelihood of serious side effects including osteoporosis, diabetes, vision problems, infections, kidney issues, and even anxiety or depression. In other words, the very drugs meant to control symptoms can slowly compromise overall health.
The WAYFINDER findings suggest that tezepelumab may help patients finally escape that trade-off. As the authors concluded, the treatment “can enable patients with OCS-dependent severe, uncontrolled asthma to effectively reduce their OCS use and its associated burden.”
Darush Attar-Zadeh, a clinical respiratory pharmacist at the North West London Integrated Care Board, welcomed these results, noting, “Only a small fraction of my asthma patients have severe disease, but those who depend on daily OCS face enormous challenges. It would be a game changer if they could move away from routine steroid use altogether.” He also urged for continuous data review: “As more studies confirm the benefits of reducing steroid dependence, NICE and policy-makers should reconsider whether access thresholds remain appropriate.”
Meanwhile, Asthma + Lung UK reports that about 7.2 million people in the UK live with asthma, around 4% of whom have severe forms. Samantha Walker, the charity’s director of research and innovation, called the new findings “an incredibly encouraging step toward transforming care for people with severe asthma.” She also voiced concern about funding shortages: “While research like this offers new hope, lung health research remains dangerously underfunded—even though lung conditions are the third leading cause of death in the UK.”
Ellen Forty, research networks and partnership manager at the same charity, added that previous studies had already hinted at tezepelumab’s potential to reduce OCS dependence. What’s new, she explained, is that this study provides a validated, step-by-step clinical approach for doctors to safely lower oral steroid doses as patients transition to tezepelumab. “These results help reinforce the idea that biologics can shift patients away from long-term oral steroids—a treatment path fraught with harmful side effects,” Forty said. She also suggested that this approach could serve as a model for integrating other biologic therapies in severe asthma care.
So here’s the question for the asthma community: If a once-a-month injection can help phase out daily steroids and their side effects, should health authorities expand access to such treatments sooner rather than later? Or does more long-term evidence still need to emerge before making that leap? What do you think—cautious optimism or full-speed ahead?
