{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T15:19:57Z","timestamp":1794410397167,"version":"4.9.0"},"reference-count":45,"publisher":"European Respiratory Society (ERS)","issue":"4","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2026,1,20]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Small airway dysfunction (SAD) is a key feature of severe asthma, contributing to poor symptom control and exacerbations. Tezepelumab has demonstrated efficacy in reducing exacerbations and improving lung function, but its specific effects on SAD remain underexplored. We aimed to assess changes in SAD among patients initiating tezepelumab.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A prospective observational study was carried out among patients with severe asthma treated with tezepelumab in a tertiary centre. SAD was assessed at baseline and 6\u2005months using impulse oscillometry (IOS) and spirometry. We focused on frequency dependence of resistance (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sub>5\u201320<\/jats:sub>\n                      ) and the area under the reactance curve (AX) to define SAD, with pathological cut-offs &gt;0.1\u2005kPa\u00b7L\n                      <jats:sup>\u22121<\/jats:sup>\n                      \u00b7s\n                      <jats:sup>\u22121<\/jats:sup>\n                      and &gt;1.0\u2005kPa\u00b7L\n                      <jats:sup>\u22121<\/jats:sup>\n                      , respectively. Paired analyses were used to compare changes over time.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      34 patients were included (median age 60\u2005years, 74% females, 21% biologic-experienced) with a median follow-up of 183\u2005days. There were significant improvements from baseline to follow-up in forced expiratory volume in 1\u2005s (FEV\n                      <jats:sub>1<\/jats:sub>\n                      ) (median 1.73\n                      <jats:italic>versus<\/jats:italic>\n                      1.97\u2005L, p=0.001), mid-expiratory flow at 25\u201375% of forced vital capacity (FVC) (median 1.26\n                      <jats:italic>versus<\/jats:italic>\n                      1.73\u2005L\u00b7s\n                      <jats:sup>\u22121<\/jats:sup>\n                      , p=0.002),\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sub>5\u221220<\/jats:sub>\n                      (median 0.16\n                      <jats:italic>versus<\/jats:italic>\n                      0.08\u2005kPa\u00b7L\n                      <jats:sup>\u22121<\/jats:sup>\n                      \u00b7s\n                      <jats:sup>\u22121<\/jats:sup>\n                      , p&lt;0.001) and AX (median 1.62\n                      <jats:italic>versus<\/jats:italic>\n                      0.80\u2005kPa\u00b7L\n                      <jats:sup>\u22121<\/jats:sup>\n                      , p&lt;0.001). Improvements in IOS parameters were larger in patients with increased Asthma Control Test (ACT) scores \u22653 points. Prevalence of SAD decreased from 76% to 44% at follow-up (p=0.003). SAD at follow-up was associated with smoking, lower FEV\n                      <jats:sub>1<\/jats:sub>\n                      and FVC, and smaller improvements in ACT score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Tezepelumab significantly improved small airway function, which was associated with better asthma control. Our findings highlight SAD as a treatable trait in patients with severe asthma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/23120541.01593-2025","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T18:55:24Z","timestamp":1771268124000},"page":"01593-2025","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Improvements in small airway dysfunction and respiratory symptoms following tezepelumab for severe 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Moshe","family":"Amor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Enghelberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7272-5284","authenticated-orcid":false,"given":"Ophir","family":"Freund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Bar-Shai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"2026072004301123000_12.4.01593-2025.1","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1016\/S2213-2600(21)00536-1","article-title":"The role of small airway dysfunction in asthma control and exacerbations: a longitudinal, observational analysis using data from the ATLANTIS 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