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NewsA first-in-class monoclonal antibody, tozorakimab, significantly reduced moderate and severe COPD exacerbations by up to 34% in two replicate phase 3 trials (OBERON and TITANIA), published in the New England Journal of Medicine. Crucially, benefits held across all patients regardless of blood eosinophil levels or smoking status — a first for a COPD biologic. AstraZeneca anticipates an FDA decision in early 2027.
A new biologic therapy is showing real promise for the millions of COPD patients who keep having flare-ups despite being on maximum inhaled therapy. Tozorakimab, an anti-IL-33 monoclonal antibody developed by AstraZeneca, cut the annual rate of moderate-to-severe exacerbations by 29–34% in former smokers and ~29–30% in the overall population across two replicate phase 3 trials — OBERON and TITANIA — presented at the European Respiratory Society 2026 Congress and simultaneously published in the New England Journal of Medicine.
What makes tozorakimab stand out is its broad reach. Unlike existing approved COPD biologics that only work in patients with elevated eosinophils, tozorakimab targets IL-33 — an upstream "alarm signal" released by damaged airway cells — and blocks both its inflammatory and tissue-remodeling effects. This means it works across the full spectrum of COPD patients, including those with low eosinophil counts who currently have few targeted options.
By the Numbers:
Why it matters: Over 50% of COPD patients on guideline-based inhaled therapy still suffer frequent exacerbations, which accelerate lung decline and raise mortality risk. Tozorakimab's ability to benefit a broad, biomarker-unselected population could meaningfully expand treatment options for this underserved group.
