The phase 3 CROSSING trial found Tezspire produced higher histologic remission rates than placebo at week 52 in people with eosinophilic esophagitis (EoE), alongside improved swallowing scores. The tissue-based response was recorded in 67.8% of patients on 210 mg and 63.3% on 420 mg, compared with 5.4% in the placebo group. Adjusted mean swallowing symptom scores fell by 22.1 and 24.0 points for the two Tezspire doses, respectively, versus 13.2 points with placebo.
The study enrolled 368 people ages 12 to 80 and compared Tezspire injections of 210 mg and 420 mg, administered every four weeks, with placebo. Participants could keep taking stable EoE medicines, including proton pump inhibitors and swallowed topical corticosteroids. For the tissue measure, remission required a peak count of no more than six eosinophils per high-power field in esophageal tissue.
At week 24, remission was reached by 64.8% in the lower-dose group and 68.9% in the higher-dose group, versus 3.5% on placebo; both comparisons had p-values below 0.001. Adjusted mean Dysphagia Symptom Questionnaire scores dropped by 18.8 points with 210 mg and 22.0 points with 420 mg, compared with 14.7 points on placebo. The lower-dose symptom comparison had a p-value of 0.049, while the higher-dose comparison was below 0.001. The questionnaire is a patient-reported measure of swallowing symptoms.
The week-52 endoscopic assessment was separate from the tissue remission measure. No visible EoE features were seen at endoscopy in 34.4% of the 210-mg group and 29.5% of the 420-mg group, compared with 4.1% on placebo. In the safety reporting, nasopharyngitis (an upper respiratory infection), headache and diarrhea topped the adverse-event list for Tezspire recipients. U.S. approval covers severe asthma and chronic rhinosinusitis with nasal polyps; Tezspire is not approved to treat EoE. AstraZeneca said it plans to share the findings with regulators.
