TICSAB

• Research type

  Research Study

• Full title

  Tailoring Inhaled Corticosteroids in patients with Severe Asthma taking Biologics

• IRAS ID

  346249

• Contact name

  Brian J Lipworth

• Contact email

  b.j.lipworth@dundee.ac.uk

• Sponsor organisation

  University of Dundee

• Duration of Study in the UK

  1 years, 1 months, 4 days

• Research summary

  Asthma is a lung disease affecting the airways (tubes of the lungs) that affects millions of people globally. The presence of airway twitchiness, also known as airway hyper-responsiveness, is one of the key features of persistent asthma. It has been shown that asthmatic patients with airway twitchiness have significantly higher levels of blood cells called eosinophils, and higher levels of a molecule called fractional exhaled nitric oxide (FeNO).
  Together, blood eosinophils and FeNO can indicate a specific form of airway inflammation also known as type 2 inflammation. Traditionally, a preventive inhaler containing a drug called corticosteroids (ICS) are used to treat this but cannot penetrate down into the smallest airways of the lungs. When these small airways are affected by asthma it is called small airways dysfunction and if this is present, people are more likely to have worse symptoms along with increased exacerbations. Biologic medications (injectables) act on targeting this type 2 inflammation and improving control of airway twitchiness. We also know there are adverse effects associated with long term high dose inhaled corticosteroid use.
  In this study, we aim to assess if two commonest biologic medications improve airway twitchiness in severe asthma patients with type 2 inflammation to the point that the dose of inhaled corticosteroid may be reduced while maintaining control of the disease.
  We will perform a study recruiting 46 patients with severe asthma who are already taking one of the two asthma biologics (dupilumab or tezepelumab – 23 for each medication). At two visits over 6 months (0 and 6 months), we will perform blood tests looking at the eosinophils, breathing tests to look at the how the lungs perform including small airways dysfunction and a mannitol challenge test which specifically assesses how twitchy the airways are as patients taper their inhaled corticosteroid dose.
  

• REC name

  East of Scotland Research Ethics Service REC 1

• REC reference

  25/ES/0043

• Date of REC Opinion

  8 Jul 2025

• REC opinion

  Further Information Favourable Opinion