Trial reportNEJM evidence2023
Tezepelumab and Mucus Plugs in Patients with Moderate-to-Severe Asthma.
Trial report in NEJM evidence, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03688074 (A Phase 2, Randomized, Double-blind, Parallel Group, Placebo Controlled Study to Evaluate the Effect of Tezepelumab on Airway Inflammation in Adults With Inadequately Controlled Asthma on Inhaled Corticosteroids and at Least One Additional Asthma Controller), which is not on this map. Cited by 62 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Phase 2, Randomized, Double-blind, Parallel Group, Placebo Controlled Study to Evaluate the Effect of Tezepelumab on Airway Inflammation in Adults With Inadequately Controlled Asthma on Inhaled Corticosteroids and at Least One Additional Asthma Controller (CASCADE)
Who cites it
62 citing papers in PubMed, 1 synthesis or guideline pooled it, 92 citations in OpenAlex.
- Effectiveness of biologics for reducing occlusive mucus plugs in patients with severe asthma: a systematic review.Respiratory research · 2026Pooled it
- A phase 2a trial of the IL-33 monoclonal antibody tozorakimab in patients with COPD: FRONTIER-4.The European respiratory journal · 2025Trial
- Clinical response and on-treatment clinical remission with tezepelumab in a broad population of patients with severe, uncontrolled asthma: results over 2 years from the NAVIGATOR and DESTINATION studies.The European respiratory journal · 2024Trial
- Effectiveness of mepolizumab on mucus plugs and clinical outcomes in severe eosinophilic asthma with and without coexisting bronchiectasis: a prospective pilot study.ERJ open research · 2026Article
- Airway mucus plugs in asthma and chronic obstructive pulmonary disease: pathobiology, imaging, and implications for clinical trials.American journal of respiratory and critical care medicine · 2026Review
- COPD Biologics: Right Patient, Right Pathway, Right Time.Pulmonary therapy · 2026Review
- Mechanisms and therapeutic strategies of asthma: from bench to bedside.Signal transduction and targeted therapy · 2026Review
- TSLP impairs mucociliary transport by inhibiting JAK signaling in both central and peripheral airways.Pflugers Archiv : European journal of physiology · 2026Article
- Reply to Zhao et al.: Clarifying structural-functional coupling by FeNO status in VESTIGE.American journal of respiratory and critical care medicine · 2026Article
- Imaging endpoints for biologic therapy in chronic obstructive pulmonary disease.The British journal of radiology · 2026Review
- Impact of Biologics on Oscillometry Defined Small Airway Dysfunction in Uncontrolled Asthma.Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2026Review
- 3D CT-Based quantification of airway structural changes during asthma exacerbations: a retrospective observational study.BMC pulmonary medicine · 2026Observational
- Mucus Plugging as a Treatable Trait Across the Asthma-COPD Spectrum: The Role of Type 2 Cytokine Blockade and Quantitative Imaging.Biomedicines · 2026Review
- Imaging in Chronic Obstructive Pulmonary Disease: Ready for Prime Time?Tuberculosis and respiratory diseases · 2026Article
- Mucus Plugs and Eosinophilic Inflammation: Expanding the Paradigm to COPD.The journal of allergy and clinical immunology. In practice · 2026Review
- Asthma endotypes and theratypes.Chinese medical journal pulmonary and critical care medicine · 2026Review
- Functional respiratory imaging reveals early structural and functional airway responses to benralizumab in severe eosinophilic asthma.BMJ open respiratory research · 2026Article
- Airway Quantification Using Ultra-Low-Dose Computed Tomography Correlates With Pulmonary Function Indices in Patients With Asthma.Journal of Korean medical science · 2026Article
- Progress in treating mucus plugs in asthma.American journal of respiratory and critical care medicine · 2026Article
- A simple index for predicting mucus plugs in patients with chronic obstructive pulmonary disease.American journal of respiratory and critical care medicine · 2026Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
13 authors at 10 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMucus plugs in asthmatic airways are associated with airway obstruction and the activity of inflammatory cytokines, specifically interleukin (IL)-5 and IL-13, and they may provide an opportunity for targeted therapy. This analysis of the CASCADE (Study to Evaluate Tezepelumab on Airway Inflammation in Adults With Uncontrolled Asthma) placebo-controlled trial used computed tomography (CT) imaging to assess mucus plugs in patients with moderate-to-severe, uncontrolled asthma who received tezepelumab or placebo.
methodsCASCADE was an exploratory, double-blind, placebo-controlled trial examining the anti-inflammatory effect of tezepelumab. Patients (aged 18 to 75 years old) were randomly assigned 1:1 to 210 mg tezepelumab or placebo every 4 weeks subcutaneously for at least 28 weeks. An expert radiologist, blinded to treatment groups and time points, objectively scored 18 lung segments for the presence of mucus plugs in CT scans obtained before and after treatment; greater numbers of mucus plugs resulted in higher mucus plug scores.
resultsAbsolute change from baseline (mean [±standard deviation]) in mucus plug score was −1.7±2.6 in patients receiving tezepelumab (n=37) and 0.0±1.4 in patients receiving placebo (n=45). At baseline, mucus plug scores correlated positively with levels of inflammatory biomarkers (blood eosinophils, eosinophil-derived neurotoxin, fractional exhaled nitric oxide, IL-5, and IL-13) and negatively with lung function measures (prebronchodilator forced expiratory volume in 1 second and forced mid-expiratory flow). In tezepelumab recipients, reductions in mucus plug scores were correlated with improvements in lung function and reductions in blood eosinophil count and levels of eosinophil-derived neurotoxin, a biomarker of eosinophilic degranulation.
conclusionsTezepelumab was associated with a reduction in occlusive mucus plugs versus placebo in a randomized controlled trial in patients with moderate-to-severe, uncontrolled asthma. (Funded by AstraZeneca and Amgen Inc.; ClinicalTrials.gov number, NCT03688074.)
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.