Severe asthma remains a significant health challenge worldwide, particularly for patients who rely on long-term oral corticosteroids (OCS) to control symptoms. While oral steroids can be effective in managing severe asthma, prolonged use is associated with numerous health risks, including cardiovascular disease, osteoporosis, diabetes, adrenal suppression, and reduced quality of life.
A recent Phase 3 clinical trial known as SUNRISE has provided encouraging evidence that tezepelumab, a biologic therapy targeting thymic stromal lymphopoietin (TSLP), may help patients reduce their dependence on oral corticosteroids while maintaining asthma control. The findings represent an important advancement in the treatment of severe, oral corticosteroid-dependent asthma.
For decades, oral corticosteroids have been used as an add-on treatment for patients whose asthma remains uncontrolled despite inhaled corticosteroids and other controller medications. Although effective, long-term steroid use can result in serious complications.
Research has shown that even relatively low cumulative steroid exposure can increase the risk of adverse health outcomes. Patients receiving maintenance doses of 5 mg or more daily may face elevated risks of metabolic disorders, psychiatric complications, eye diseases, gastrointestinal problems, and increased mortality.
As a result, reducing steroid exposure without compromising asthma control has become a major goal in modern asthma management.
Tezepelumab is a human monoclonal antibody that blocks thymic stromal lymphopoietin (TSLP), an important cytokine involved in the inflammatory pathways that drive asthma.
Unlike some biologic therapies that target specific inflammatory markers such as eosinophils, tezepelumab works earlier in the inflammatory cascade. This broader mechanism allows it to potentially benefit a wider range of severe asthma patients.
Previous clinical studies demonstrated that tezepelumab can reduce asthma exacerbations, improve lung function, and enhance quality of life. The SUNRISE trial was designed specifically to investigate whether the therapy could also reduce reliance on maintenance oral corticosteroids.
SUNRISE was a multicentre, randomized, double-blind, placebo-controlled Phase 3 study conducted across 63 sites in 12 countries.
The trial enrolled adults aged 18 to 80 years who had physician-diagnosed severe asthma and were dependent on maintenance oral corticosteroid therapy. Participants were randomly assigned in a 2:1 ratio to receive either:
The treatment period lasted 28 weeks.
Researchers evaluated whether participants could reduce their daily maintenance oral corticosteroid doses while maintaining asthma control.
Although the study was terminated early because of recruitment challenges, 122 participants were successfully enrolled and analyzed.
The primary endpoint focused on the percentage reduction in daily oral corticosteroid dose while maintaining asthma stability.
Results showed that participants receiving tezepelumab had significantly greater odds of achieving higher levels of steroid reduction compared with placebo.
The odds ratio was 2.93, indicating that patients treated with tezepelumab were nearly three times more likely to achieve meaningful corticosteroid dose reductions.
Among patients receiving tezepelumab:
These outcomes suggest that tezepelumab can substantially reduce steroid dependence in many patients with severe asthma.
Lung function was assessed using pre-bronchodilator forced expiratory volume in one second (FEV1).
Patients receiving tezepelumab experienced a significant improvement compared with placebo.
The treatment group achieved an average improvement of 0.24 liters, while placebo recipients showed little change. The difference between groups exceeded the threshold generally considered clinically meaningful.
Improvements were observed as early as four weeks after treatment initiation and were maintained throughout the study period.
Asthma exacerbations remain one of the most serious complications of severe asthma.
The SUNRISE trial found that:
The annualized asthma exacerbation rate was reduced by approximately 69% with tezepelumab compared with placebo.
Hospitalizations and emergency department visits related to asthma were also significantly lower in the tezepelumab group.
Researchers evaluated patient-reported outcomes using validated assessment tools, including:
Patients treated with tezepelumab reported greater improvements in symptom control and overall quality of life compared with placebo.
These findings indicate that reducing oral corticosteroid use did not come at the expense of asthma stability or patient well-being.
Safety was a critical component of the SUNRISE study.
Overall adverse events occurred in:
Serious adverse events were reported in:
The most common side effects included:
Three deaths occurred during the study, but investigators determined that none were related to the study treatment.
Importantly, researchers identified no new safety concerns associated with tezepelumab.
The SUNRISE trial addresses an important unmet need in asthma care. Long-term steroid dependence can significantly impact physical health, mental well-being, and healthcare costs.
By enabling substantial reductions in oral corticosteroid use while maintaining asthma control, tezepelumab offers a potential alternative strategy for managing severe asthma.
The results are particularly meaningful because they were observed across different blood eosinophil levels, suggesting broader applicability than some other biologic therapies.
As clinical practice increasingly moves away from chronic oral corticosteroid use, therapies that effectively reduce steroid exposure are becoming increasingly valuable.
The findings from SUNRISE build upon previous evidence from the SOURCE and WAYFINDER studies. Together, these trials suggest that tezepelumab may play a significant role in reducing steroid burden among patients with severe asthma.
While the early termination of SUNRISE limited the sample size, the study still achieved its primary endpoint and demonstrated consistent benefits across multiple clinical outcomes.
Future real-world studies and longer-term research will help clarify the full impact of tezepelumab on long-term asthma management and patient outcomes.
The Phase 3 SUNRISE trial provides strong evidence that tezepelumab can help adults with severe, oral corticosteroid-dependent asthma significantly reduce maintenance steroid use while preserving asthma control. Patients receiving tezepelumab experienced fewer exacerbations, improved lung function, better quality of life, and no new safety concerns.
As healthcare providers continue seeking strategies to minimize steroid-related complications, tezepelumab represents a promising treatment option that may improve outcomes for patients living with severe asthma.
Wechsler ME, Brightling CE, Brusselle G, Caminati M, Soler T, Montaño González E, et al. 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 trial. The Lancet Respiratory Medicine. Volume 14, Issue 6, June 2026, Pages 481–492.
This article is intended for informational and educational purposes only. It summarizes findings from a published clinical trial and should not be considered medical advice. Patients should consult qualified healthcare professionals before making any changes to their asthma treatment plans. The safety and effectiveness of any medication should be evaluated based on individual medical circumstances and current clinical guidelines.
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