WHAT THE STUDY ACTUALLY SAYS

Can an asthma biologic get patients off long-term steroids? Mostly, a trial finds.

35% of patients on tezepelumab stopped oral steroids entirely, versus 21% on placebo, without losing asthma control — in a drug that targets inflammation upstream of the eosinophil count doctors usually check.

Patients who stopped oral corticosteroids entirely at 28 weeksTezepelumab: 35%; Placebo: 21%0%20%40%Tezepelumab35%Placebo21%
Patients who stopped oral corticosteroids entirely at 28 weeks
GroupValue (%)
Tezepelumab35
Placebo21
Patients who stopped oral corticosteroids entirely at 28 weeks SUNRISE enrolled adults with severe, oral-corticosteroid-dependent asthma. Source: National Jewish Health

Results from the Phase 3 SUNRISE trial, published in The Lancet Respiratory Medicine, show that tezepelumab let adults with severe, oral-corticosteroid-dependent asthma cut their steroid dose — and in over a third of cases, stop taking steroids entirely — without losing control of their disease [s1].

The problem the trial was built to address

A subset of people with severe asthma rely on daily oral corticosteroids on top of high-dose inhaled therapy to keep their disease controlled, because inhaled treatment alone isn't enough. That daily oral steroid exposure is itself a long-term liability. "Long-term oral corticosteroid use can have devastating consequences for patients, including diabetes, osteoporosis, cardiovascular disease and significant impacts on quality of life," said Michael Wechsler, MD, the study's lead author and director of the Cohen Family Asthma Institute at National Jewish Health [s1]. The clinical goal SUNRISE tested was narrow and practical: can a biologic drug let these patients reduce or stop the oral steroid without their asthma getting worse.

What the trial found

SUNRISE was a multicenter, double-blind, placebo-controlled Phase 3 trial in adults with severe, oral-corticosteroid-dependent asthma [s1]. Over a 28-week treatment period, 69% of patients receiving tezepelumab achieved at least a 50% reduction in their oral corticosteroid dose, compared with 44% of patients on placebo [s1]. More strikingly, 35% of tezepelumab patients stopped oral corticosteroids completely, versus 21% of those on placebo [s1]. Patients treated with tezepelumab were, overall, nearly three times more likely than placebo patients to achieve a greater steroid-dose reduction while maintaining asthma control [s1].

The dose reduction was not achieved at the cost of worse disease control. The trial also reported clinically meaningful improvements in lung function, asthma symptom control and quality of life among tezepelumab-treated patients, along with significantly fewer asthma exacerbations — including fewer emergency department visits and hospitalizations — relative to placebo [s1].

Why the mechanism is the notable part

Tezepelumab is a monoclonal antibody that targets thymic stromal lymphopoietin (TSLP), an epithelial cytokine that sits upstream of several of the inflammatory pathways involved in asthma [s1]. That matters because most existing asthma biologics are targeted at a specific downstream inflammatory signature — commonly patients with elevated eosinophil counts or allergic markers — which limits who can be prescribed them based on a blood test result. Researchers on the trial reported that tezepelumab's benefit held across a broad range of patients, including those with varying eosinophil levels, rather than being concentrated in one biomarker-defined subgroup [s1]. "These results build on growing evidence that targeting upstream inflammation pathways can provide meaningful benefits for patients with severe asthma," Dr. Wechsler said [s1].

What the results do not settle

The trial measured outcomes through 28 weeks — the results describe what happens over roughly seven months of treatment, not what happens if a patient stays on tezepelumab, or stays off oral steroids, for years. Nor do the topline figures reported here indicate what fraction of patients who stopped or reduced oral steroids later needed to resume them after the study window closed. The 31% of tezepelumab patients who did not achieve a 50% dose reduction, and the 65% who did not stop oral steroids entirely, are a reminder that the drug did not work for everyone in the trial — SUNRISE shows a meaningfully better rate of steroid reduction than placebo, not a treatment that reliably eliminates oral steroid dependence.

Dr. Wechsler framed the finding as addressing a genuine clinical tension rather than resolving it outright: "For many patients with severe asthma, oral corticosteroids are a double-edged sword," he said. "They can help control symptoms, but long-term use often comes at a high physical cost. The ability to reduce steroid exposure while still controlling disease activity represents a major goal in asthma care" [s1].

What to watch

Whether longer follow-up data show the steroid reductions holding beyond 28 weeks, and whether patients who stopped oral corticosteroids entirely remain steroid-free over time or relapse. Also worth tracking: how the trial's outcomes vary by baseline eosinophil count and other biomarkers, since a drug that works independent of a specific inflammatory signature would represent a meaningfully different prescribing model than the biomarker-gated biologics already on the market for severe asthma.

Sources

Sources

  1. Study Finds Tezepelumab Helps Patients with Severe Asthma Reduce Oral Steroid Use While Maintaining Asthma ControlNational Jewish Health , May 28, 2026
  2. Efficacy and safety of tezepelumab versus placebo in reducing oral corticosteroid use in adults with severe, oral corticosteroid-dependent asthma (SUNRISE): a multicentre, placebo-controlled, double-blind, phase 3 trialThe Lancet Respiratory Medicine , May 18, 2026
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