Azithromycin vs Tezpire/tezepelumab

[Docdan]

Hi there.

I was wondering if anyone on these drugs can give input into what works best for them. I randomly got diagnosed in my 30s with asthma last year, normally fit and well. I have been in and out of hospitals since last year with horrific exacerbations, and have been unable to work for a year. My lung function tests have always been relatively “normal” and FeNo pretty uneventful as well but I was still getting sick as a dog. I am currently on Trimbow (high dose), and Montelukast, using my salbutamol pretty much daily.

After waiting for months, I have been seen by a consultant who confirmed that I have severe non-eosinophilic, non-inflammatory asthma. And has given me the option of adding Azithromycin to my regimen or trying Tespire/tezepelumab. She seems to think they will give similar outcomes but I was wondering if anyone, from their personal experiences with either, could share their own experiences.

Also if anyone has been pregnant on biologics, please let me know how you got on as it’s something I also have to consider for the near future also. Thank you.

[Drew456]

I been on same situation severe bronco-spasms on trelegy and Tezspire had relieve for 6 months now I’m back same struggle calling out work ect. Lung function test and other test comes back good. Now I’m looking for other options of relieve.

[teddyd in reply to Drew456]

I have been on Azithromycin for years it has made a huge difference. The number of infections have decreased. I still get flare ups and bad asthma days but much fewer than before.

[MikeWhite]

I was in the same situation a couple of years ago - added in Azithromycin 3 times a week & as per Teddyd I have too seen a dramatic reduction in hosp admissions, down from being off work all winter with 4 or 5 times in resus to only one hosp admission per year on average

NB I was put on biological Xolair a couple of years before the Azithromycin

[peege]

I'm nothing like you Docdan, however I've a propensity to lung infections with my asthma. I take Azithromycin 250mgs on Mon Wed and Fri from November to April. Its been a game changer. Several winters without infection, two last year and none this year - so far

[Poobah]

I'm non-eosinophilic too and Azithromycin is a game changer for me. I'm fortunate not to have it regularly, but only if I suffer a bad patch of asthma control. My normal programme would be 1 dose every other day, total 3 doses a week. 4 month course.

It's so much more effective than oral steroids and reduces any inflammation. It's to do with the endotype inflammatory pathways in non-eosinophilic asthma.

Both my siblings are on biologics for rheumatoid arthritis and the side effects are the challenge for them. Given the choice between Azithromycin and biologics, I would try Azithromycin first and if that didn't deliver good results, I would then try the biologics.

Azithromycin isn't without a risk of side effects, no medication is, but it may be potentially less than a biologic. Obviously, one only discovers these outcomes by trying the medication.