Tozorakimab Reduces COPD Exacerbations via IL-33 Blockade in Phase 3 trial

The phase 3 MIRANDA trial showed that add-on tozorakimab significantly reduced moderate-to-severe exacerbations in patients with chronic obstructive pulmonary disease (COPD), particularly in former smokers already on inhaled therapy. As an IL-33–targeting monoclonal antibody, it acts on upstream inflammatory pathways (Th1/Th2) and epithelial dysfunction, highlighting its potential as a novel treatment strategy for high-risk COPD patients.

In MIRANDA, patients received tozorakimab 300mg or placebo on top of standard of care once every two weeks.1 The trial enrolled patients with COPD still experiencing moderate-to-severe exacerbations while on inhaled standard of care. These results follow an announcement in March of the positive high-level results from the pivotal Phase III OBERON and TITANIA trials studying tozorakimab at a four-week dosing interval.

Frank Sciurba, MD, FCCP, Professor of Pulmonary and Critical Care Medicine, University of Pittsburgh, Chief Investigator of LUNA program said: “These results add to the growing body of evidence that indicates tozorakimab delivered meaningful clinical benefits for COPD patients who urgently need new treatment options. Up to half of patients today still experience exacerbations even when taking standard-of-care inhaled therapies, putting them at risk of serious health consequences including hospitalization and even death.”

Sharon Barr, Executive Vice President, BioPharmaceuticals R&D, AstraZeneca, said: “These data further demonstrate tozorakimab’s exciting potential as a first-in-class biologic with a truly differentiated mechanism of action that inhibits the signaling of the reduced and oxidized forms of IL-33 to address underlying drivers of COPD. We look forward to sharing the data with regulators and the scientific community as soon as possible.”

Tozorakimab was generally well tolerated with a favorable safety profile consistent with previous trials. The data will be submitted to regulatory authorities and shared with the scientific community at an upcoming medical meeting.

Nearly 400 million people are diagnosed with COPD, a heterogenous and progressive disease and the 3rd leading cause of death globally. Even when on inhaled standard of care, more than 50% of patients experience exacerbations, putting them at an increased risk of cardiopulmonary events and mortality.

Tozorakimab is a potential first-in-class monoclonal antibody targeting interleukin-33 (IL-33), that uniquely inhibits the signaling of the reduced and oxidized forms of IL-33, offering the potential to both reduce inflammation and disrupt the cycle of mucus dysfunction that contribute to COPD worsening.

Tozorakimab is also being studied in a Phase III trial for severe viral lower respiratory tract disease and in a Phase II trial in asthma.