Announcement • 2h
Astrazeneca Demonstrates Positive Phase Iii Results for Tezspire in Eosinophilic Esophagitis
AstraZeneca issued that TEZSPIRE demonstrated positive Phase III results in eosinophilic esophagitis across both co-primary and all key secondary endpoints. Statistically significant and clinically meaningful disease and symptom improvements compared to placebo maintained through week 52. Efficacy in a third epithelial-driven inflammatory disease supports broad potential of TEZSPIRE. Positive high-level results from the Phase III CROSSING trial in patients with eosinophilic esophagitis (EoE) showed that AstraZeneca and Amgen's TEZSPIRE (tezepelumab-ekko) demonstrated statistically significant and clinically meaningful improvements across both co-primary and all key secondary endpoints at week 24, which were sustained through week 52 in both doses tested. The co-primary endpoints were histologic remission and the frequency and severity of dysphagia (difficulty swallowing) compared to placebo. The safety profile of TEZSPIRE in the trial was generally consistent with its approved indications. CROSSING is a randomized, double-blind trial that evaluated the efficacy and safety of TEZSPIRE administered subcutaneously every four weeks compared to placebo in adults and adolescents with symptomatic and uncontrolled EoE while on maintenance therapy. In the trial, the first co-primary endpoint, histologic remission, was defined as having a low count of peak eosinophils in the esophageal tissue. The second co-primary endpoint, the frequency and severity of dysphagia, was assessed using the patient-reported Dysphagia Symptom Questionnaire (DSQ) and measured as a mean change from baseline in DSQ score. Full results will be shared with regulatory authorities and the scientific community at an upcoming medical meeting. TEZSPIRE is a first-in-class human monoclonal antibody that inhibits the action of thymic stromal lymphopoietin (TSLP), a key epithelial cytokine that sits at the top of multiple inflammatory cascades. TEZSPIRE is currently approved for the treatment of severe asthma in the US, EU, China, Japan and more than 70 countries across the globe, and for the treatment of chronic rhinosinusitis with nasal polyps (CRSwNP) in the US, EU, China and Japan. The Phase III JOURNEY and EMBARK trials evaluating TEZSPIRE in chronic obstructive pulmonary disease (COPD) are ongoing. The most common adverse reactions (incidence 3%) are: Asthma: pharyngitis, arthralgia, and back pain. Chronic rhinosinusitis with nasal polyps: nasopharyngitis, upper respiratory tract infection, epistaxis, pharyngitis, back pain, influenza, injection site reaction and arthralgia. There are no available data on TEZSPIRE use in pregnant women to evaluate for any drug-associated risk of major birth defects, miscarriage, or other adverse maternal or fetal outcomes. Placental transfer of monoclonal antibodies such as tezepelumab-ekko is greater during the third trimester of pregnancy; therefore, potential effects on a fetus are likely to be greater during the third trimester of pregnancy. TEZSPIRE is indicated for: the add-on maintenance treatment of adult and pediatric patients aged 12 years and older with severe asthma. TEZSPIRE is not indicated for the relief of acute bronchospasm or status asthmaticus. The add-on maintenance treatment of adult and pediatric patients aged 12 years and older with inadequately controlled chronic rhinosinusitis with nasal polyps (CRSwNP). CROSSING is a randomized, double-blind, placebo-controlled, multi-center, parallel-group, Phase III trial designed to evaluate the efficacy and safety of TEZSPIRE administered subcutaneously every four weeks, compared to placebo in patients aged 12-80 years with symptomatic and histologically active EoE. A total of 368 patients were randomized in a 1:1:1 ratio to receive either a low or high dose of TEZSPIRE or placebo. The co-primary endpoints analyzed at Week 24 were the proportion of patients with histologic remission, defined as a peak esophageal eosinophil count less than or equal to six eosinophils per high-power field, and mean changes from baseline in the DSQ. The peak eosinophil count is obtained when biopsies of the tissue of the esophagus are examined under a microscope. A count of 15 or more peak eosinophils per high power microscopic field measured by esophageal biopsy is often the cutoff used to diagnose EoE. The DSQ captures the presence and severity of dysphagia symptoms in a daily diary with a four-item patient-reported questionnaire; the score is calculated over 14-day periods, ranging from zero to 84, with a higher score indicating more severe dysphagia. Key secondary endpoints assessed histologic remission and dysphagia symptoms at Week 52; changes in endoscopic disease features (EoE-EREFS) and histologic severity and extent (EoE-HSS) at Weeks 24 and 52; as well as endoscopic response, inflammatory remission and total endoscopic remission at Week 52. In the trial, patients were allowed to remain on background medications for EoE, including proton pump inhibitors and swallowed topical corticosteroids, provided that they were stable prior to entry and during the treatment period. Tezepelumab is being developed by AstraZeneca in collaboration with Amgen as a first-in-class human monoclonal antibody that inhibits the action of TSLP, a key epithelial cytokine that sits at the top of multiple inflammatory cascades. TSLP is critical in the initiation and persistence of allergic, eosinophilic and other types of epithelial-driven inflammation associated with severe asthma, CRSwNP, COPD and EoE. TSLP is released by the epithelium in response to environmental triggers. Across these disease states, the expression of TSLP is increased and correlates with disease severity. TEZSPIRE is approved as a single-use pre-filled syringe and auto-injector for self-administration in the US, EU, China and Japan. Since 2021, more than 100,000 patients have been treated with TEZSPIRE for severe asthma. In October 2021, TEZSPIRE was granted Orphan Drug Designation by the U.S. Food and Drug Administration (FDA) for the treatment of EoE. Beyond EoE, TEZSPIRE is also being explored in Phase III trials in COPD. The 2012 Collaboration Agreement between Amgen and AstraZeneca has been amended and updated over time. For TEZSPIRE, both companies continue to share costs and profits equally after payment by AstraZeneca of a mid-single-digit inventor royalty to Amgen. AstraZeneca continues to lead development and Amgen continues to lead manufacturing. All aspects of the collaboration are under the oversight of joint governing bodies. Under the agreement, Amgen and AstraZeneca jointly commercialize TEZSPIRE in the US. Amgen records product sales in the US, with AZ recording its share of US profits as Alliance Revenue. Outside of the US, AstraZeneca records product sales.