USA: Researchers have found in two studies that Tozorakimab may offer a promising new biologic treatment option for COPD patients who continue to experience exacerbations despite guideline-based therapy.

Two large double-blind trials, OBERON and TITANIA, have found that once-monthly tozorakimab, an IL-33-targeting biologic, significantly reduced moderate-to-severe COPD exacerbations when added to standard inhaled maintenance therapy.
Among former smokers, annualized exacerbation rates were:
  • OBERON: 1.34 vs 1.90 events (RR 0.71)
  • TITANIA: 1.37 vs 2.07 events (RR 0.66)
Similar benefits were observed in the overall population of current and former smokers, with exacerbation rates reduced by about 29–30% compared with placebo.
The findings were published in The New England Journal of Medicine by Frank C. Sciurba, Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Pittsburgh, Pittsburgh, and colleagues.
COPD exacerbations can accelerate disease progression, worsen lung function and increase healthcare utilization despite treatment with inhaled maintenance therapies. The researchers investigated whether targeting interleukin-33 (IL-33), a signaling molecule implicated in COPD inflammation, could provide additional protection against these episodes. Tozorakimab is a monoclonal antibody designed to block IL-33 activity.
The phase 3 OBERON and TITANIA trials enrolled adults with COPD who were current or former smokers and had experienced exacerbations during the preceding year despite stable standard-of-care inhaled therapy. Patients were not selected according to blood eosinophil levels, allowing the treatment to be evaluated across a broader COPD population.
Participants were randomly assigned to receive 300 mg of subcutaneous tozorakimab or placebo every four weeks for 52 weeks. The primary outcome was the annualized rate of moderate or severe exacerbations among former smokers, while the first key secondary outcome assessed exacerbation rates in the overall study population.
In OBERON, the overall population included 446 patients receiving tozorakimab and 431 receiving placebo. In TITANIA, 438 received tozorakimab and 435 received placebo.
The analysis showed that among former smokers, tozorakimab reduced annualized moderate-to-severe exacerbations by 29% in OBERON and 34% in TITANIA compared with placebo. In the overall population, exacerbation rates were also significantly lower, with rate ratios of 0.70 in OBERON and 0.71 in TITANIA.
Safety findings were broadly comparable between groups. Adverse events occurred in 70.4% of tozorakimab-treated patients versus 77.2% with placebo in OBERON, while rates were 80.1% and 79.8%, respectively, in TITANIA.
The researchers concluded that monthly tozorakimab significantly lowered moderate-to-severe COPD exacerbation rates among former smokers as well as the broader population of current and former smokers receiving standard inhaled maintenance treatment.
Reference:
DOI: 10.1056/NEJMoa2606998
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Article Source : The New England Journal of Medicine

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Medha Baranwal

Medha Baranwal holds a Bachelor’s degree in Biomedical Sciences from the University of Delhi and a Master’s degree in Biotechnology from Amity University. Since May 2018, she has been contributing to Medical Dialogues, writing and editing medical news articles that translate complex research into clear, accessible information for healthcare professionals.

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