{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T06:55:33Z","timestamp":1781679333428,"version":"3.54.5"},"reference-count":24,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background\/Objectives: Tezepelumab targets thymic stromal lymphopoietin and has broad efficacy in severe asthma, yet real-world evidence on patient-reported trigger burden remains limited. We assessed 12-month outcomes after tezepelumab, focusing on clinical remission, biomarkers, and trigger profiling as complementary dimensions of response. Methods: In this multicenter longitudinal real-world observational cohort based on routine clinical follow-up and Severe Asthma Network in Italy (SANI) registry data, 43 adults with severe asthma treated with tezepelumab at four Italian SANI reference centers were evaluated at baseline and, when available, after 1, 3, 6, and 12 months. Outcomes included exacerbations, lung function, type 2 biomarkers, the Asthma Control Test, SNOT-22, trigger categories, Asthma Trigger Inventory (ATI) scores, and SANI-defined clinical remission. Results: Among 22 patients with 12-month follow-up data, mean annualized exacerbations decreased from 4.30 \u00b1 2.77 to 0.36 \u00b1 0.49 (p &lt; 0.001), and 14\/22 (63.6%) were exacerbation-free. Asthma control improved, whereas FEV1 remained stable. FeNO and blood eosinophils decreased at selected time points. The number of reported trigger categories was lower at 6 months (p &lt; 0.001), and physical exertion, smoke, irritants, and infection-related ATI domains improved longitudinally. Complete clinical remission was achieved in 5\/22 patients (22.7%). Conclusions: Tezepelumab was associated with reduced exacerbations, improved asthma control, and lower patient-reported trigger burden. Structured trigger profiling may provide an exploratory patient-centered dimension for assessing treatment response in severe asthma.<\/jats:p>","DOI":"10.3390\/jpm16060321","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T15:00:48Z","timestamp":1781535648000},"page":"321","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Twelve-Month Real-World Outcomes of Tezepelumab in Severe Asthma: Clinical Remission, Biomarker Changes, and Trigger Burden\u2014A SANI Multicenter Cohort"],"prefix":"10.3390","volume":"16","author":[{"given":"Stefania","family":"Nicola","sequence":"first","affiliation":[{"name":"Immunology and Allergy Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, 10128 Turin, Italy"},{"name":"Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1267-4320","authenticated-orcid":false,"given":"Simone","family":"Negrini","sequence":"additional","affiliation":[{"name":"Immunology and Allergy Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, 10128 Turin, Italy"},{"name":"Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fulvia","family":"Ribolla","sequence":"additional","affiliation":[{"name":"Pneumology Unit, City of Health and Science, Molinette Hospital, Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3876-8587","authenticated-orcid":false,"given":"Giuseppe","family":"Guida","sequence":"additional","affiliation":[{"name":"Severe Asthma, Rare Lung Disease and Respiratory Pathophysiology Unit, San Luigi Gonzaga University Hospital, Orbassano, 10043 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco Francesco","family":"Rinaldo","sequence":"additional","affiliation":[{"name":"Pneumology Unit, City of Health and Science, Molinette Hospital, Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5754-4636","authenticated-orcid":false,"given":"Benedetta","family":"Bondi","sequence":"additional","affiliation":[{"name":"Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iuliana","family":"Badiu","sequence":"additional","affiliation":[{"name":"Immunology and Allergy Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Corradi","sequence":"additional","affiliation":[{"name":"Immunology and Allergy Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7679-2372","authenticated-orcid":false,"given":"Anna","family":"Quinternetto","sequence":"additional","affiliation":[{"name":"Immunology and Allergy Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5352-7012","authenticated-orcid":false,"given":"Ilaria","family":"Vitali","sequence":"additional","affiliation":[{"name":"Immunology and Allergy Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4201-3456","authenticated-orcid":false,"given":"Luca","family":"Lo Sardo","sequence":"additional","affiliation":[{"name":"Immunology and Allergy Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Crida","sequence":"additional","affiliation":[{"name":"Struttura Semplice Dipartimentale Pediatric Allergology Unit, Regina Margherita Children Hospital, Azienda Ospedaliero-Universitaria (AOU) Citt\u00e0 Della Salute e Della Scienza, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Mhimid","sequence":"additional","affiliation":[{"name":"Immunology and Allergy Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia Luisa","family":"Tocci","sequence":"additional","affiliation":[{"name":"Immunology and Allergy Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo","family":"Teocchi","sequence":"additional","affiliation":[{"name":"Immunology and Allergy Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asia","family":"Milione","sequence":"additional","affiliation":[{"name":"Immunology and Allergy Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Marengo","sequence":"additional","affiliation":[{"name":"Immunology and Allergy Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0492-5663","authenticated-orcid":false,"given":"Enrico","family":"Heffler","sequence":"additional","affiliation":[{"name":"Personalized Medicine Asthma and Allergy, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele Milan, 20072 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8467-2557","authenticated-orcid":false,"given":"Giorgio Walter","family":"Canonica","sequence":"additional","affiliation":[{"name":"Personalized Medicine Asthma and Allergy, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele Milan, 20072 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2285-9970","authenticated-orcid":false,"given":"Francesco","family":"Blasi","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano, 20122 Milan, Italy"},{"name":"Respiratory and Cystic Fibrosis Unit, Internal Medicine Department, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico Milano, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Paggiaro","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5316-8710","authenticated-orcid":false,"given":"Marzia","family":"Boem","sequence":"additional","affiliation":[{"name":"Immunology and Allergy Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Basiglio","sequence":"additional","affiliation":[{"name":"Immunology and Allergy Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, 10128 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucrezia","family":"Alessi","sequence":"additional","affiliation":[{"name":"Struttura Semplice Dipartimentale Pediatric Allergology Unit, Regina Margherita Children Hospital, Azienda Ospedaliero-Universitaria (AOU) Citt\u00e0 Della Salute e Della Scienza, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fulvio","family":"Braido","sequence":"additional","affiliation":[{"name":"Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1826-5018","authenticated-orcid":false,"given":"Fabio Luigi Massimo","family":"Ricciardolo","sequence":"additional","affiliation":[{"name":"Severe Asthma, Rare Lung Disease and Respiratory Pathophysiology Unit, San Luigi Gonzaga University Hospital, Orbassano, 10043 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3972-2871","authenticated-orcid":false,"given":"Paolo","family":"Solidoro","sequence":"additional","affiliation":[{"name":"Pneumology Unit, City of Health and Science, Molinette Hospital, Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Bagnasco","sequence":"additional","affiliation":[{"name":"Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7249-7616","authenticated-orcid":false,"given":"Luisa","family":"Brussino","sequence":"additional","affiliation":[{"name":"Immunology and Allergy Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, 10128 Turin, Italy"},{"name":"Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the SANI Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e003144","DOI":"10.1136\/bmjresp-2025-003144","article-title":"Global, regional and national burden of asthma from 1990 to 2021: A systematic analysis","volume":"12","author":"Zhang","year":"2025","journal-title":"BMJ Open Respir. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1016\/j.jaip.2024.01.023","article-title":"Phenotyping of severe asthma in the era of broad-acting anti-asthma biologics","volume":"12","author":"Bourdin","year":"2024","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"100453","DOI":"10.1016\/j.jacig.2025.100453","article-title":"Burden of asthma by severity and exacerbation frequency among adult patients na\u00efve to biologic asthma therapy: A Finnish cohort study","volume":"4","author":"Kankaanranta","year":"2025","journal-title":"J. Allergy Clin. Immunol. Glob."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1097\/ACI.0000000000000870","article-title":"Consequences of severe asthma exacerbations","volume":"23","author":"Busse","year":"2023","journal-title":"Curr. Opin. Allergy Clin. Immunol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.jaci.2021.11.021","article-title":"Considering biomarkers in asthma disease severity","volume":"149","author":"Custovic","year":"2022","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Guida, G., Bagnasco, D., Carriero, V., Bertolini, F., Ricciardolo, F.L.M., Nicola, S., Brussino, L., Nappi, E., Paoletti, G., and Canonica, G.W. (2022). Critical evaluation of asthma biomarkers in clinical practice. Front. Med., 9.","DOI":"10.3389\/fmed.2022.969243"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/j.mucimm.2025.03.003","article-title":"Airway epithelial cells as drivers of severe asthma pathogenesis","volume":"18","author":"Dorscheid","year":"2025","journal-title":"Mucosal Immunol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1016\/j.jaci.2023.11.915","article-title":"Airway hyperresponsiveness correlates with airway TSLP in asthma independent of eosinophilic inflammation","volume":"153","author":"Andreasson","year":"2024","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1016\/j.anai.2023.03.001","article-title":"Number of patient-reported asthma triggers predicts uncontrolled disease among specialist-treated patients with severe asthma","volume":"130","author":"Chipps","year":"2023","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1056\/NEJMoa1704064","article-title":"Tezepelumab in adults with uncontrolled asthma","volume":"377","author":"Corren","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1800","DOI":"10.1056\/NEJMoa2034975","article-title":"Tezepelumab in adults and adolescents with severe, uncontrolled asthma","volume":"384","author":"Corren","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1016\/S2213-2600(21)00226-5","article-title":"Effect of tezepelumab on airway inflammatory cells, remodelling, and hyperresponsiveness in patients with moderate-to-severe uncontrolled asthma (CASCADE): A double-blind, randomised, placebo-controlled, phase 2 trial","volume":"9","author":"Diver","year":"2021","journal-title":"Lancet Respir. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/S2213-2600(22)00492-1","article-title":"Long-term safety and efficacy of tezepelumab in people with severe, uncontrolled asthma (DESTINATION): A randomised, placebo-controlled extension study","volume":"11","author":"Wechsler","year":"2023","journal-title":"Lancet Respir. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3011","DOI":"10.1016\/j.jaip.2025.07.046","article-title":"Efficacy and safety of tezepelumab in adults with severe, uncontrolled asthma in Asia: Results from the phase 3 DIRECTION study","volume":"13","author":"Yang","year":"2025","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1007\/s12325-024-03006-5","article-title":"Effect of tezepelumab on Sino-Nasal Outcome Test (SNOT)-22 domain and symptom-specific scores in patients with severe, uncontrolled asthma and a history of chronic rhinosinusitis with nasal polyps","volume":"42","author":"Jacobs","year":"2024","journal-title":"Adv. Ther."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.anai.2023.08.015","article-title":"Tezepelumab reduces exacerbations across all seasons in patients with severe, uncontrolled asthma (NAVIGATOR)","volume":"131","author":"Pavord","year":"2023","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.anai.2025.09.015","article-title":"Effect of tezepelumab on asthma exacerbations co-occurring with infection-attributed acute respiratory illnesses","volume":"136","author":"Feleszko","year":"2026","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_18","unstructured":"Global Initiative for Asthma (2026, May 31). Difficult-to-Treat & Severe Asthma in Adolescent and Adult Patients: Diagnosis and Management. Available online: www.ginasthma.org."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1097\/MCP.0000000000000439","article-title":"Novel methods for device and adherence monitoring in asthma","volume":"24","author":"Bonini","year":"2018","journal-title":"Curr. Opin. Pulm. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1097\/01.psy.0000248898.59557.74","article-title":"The asthma trigger inventory: Validation of a questionnaire for perceived triggers of asthma","volume":"68","author":"Ritz","year":"2006","journal-title":"Psychosom. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/j.jaip.2019.11.008","article-title":"Allergic Endotypes and Phenotypes of Asthma","volume":"8","author":"Casale","year":"2020","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1080\/02770903.2024.2376919","article-title":"SANI clinical remission definition: A useful tool in severe asthma management","volume":"61","author":"Canonica","year":"2024","journal-title":"J. Asthma"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Porsbjerg, C.M., Townend, J., Bergeron, C., Christoff, G.C., Katsoulotos, G.P., Larenas-Linnemann, D., Tran, T.N., Al-Lehebi, R., Bosnic-Anticevich, S.Z., and Busby, J. (2024). Association between pre-biologic T2-biomarker combinations and response to biologics in patients with severe asthma. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1361891"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Solidoro, P., Nicola, S., Ridolfi, I., Canonica, G.W., Blasi, F., Paggiaro, P., Heffler, E., Bagnasco, D., Patrucco, F., and Ribolla, F. (2022). Biologics in Severe Eosinophilic Asthma: Three-Year Follow-Up in a SANI Single Center. Biomedicines, 10.","DOI":"10.3390\/biomedicines10020200"}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/6\/321\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T06:23:24Z","timestamp":1781677404000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/6\/321"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":24,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["jpm16060321"],"URL":"https:\/\/doi.org\/10.3390\/jpm16060321","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,15]]}}}