ERS Congress 2026: Investigational biologic cuts COPD flare-ups by one-third

Clinical takeaway: Among patients with COPD who continue to have exacerbations despite optimized inhaled therapy, the investigational anti-IL-33 monoclonal antibody tozorakimab reduced moderate-to-severe flare-ups by about 30% over 1 year, with benefits seen across eosinophil levels and smoking-status subgroups.

Current COPD biologics are generally targeted to patients with elevated eosinophil counts, leaving many patients with recurrent exacerbations and limited treatment options. Tozorakimab targets interleukin-33, an upstream inflammatory mediator implicated in both airway inflammation and mucus dysfunction.

At the ERS Congress 2026, investigators presented results from the replicate phase 3 OBERON and TITANIA trials, simultaneously published in the New England Journal of Medicine. The studies enrolled more than 1,700 current and former smokers with COPD and a history of exacerbations despite standard maintenance therapy, with roughly 90% already receiving triple inhaled therapy.

Across both trials, patients receiving add-on subcutaneous tozorakimab every 4 weeks experienced about 29% to 34% fewer moderate-to-severe exacerbations than those receiving placebo. Annualized exacerbation rates fell from approximately 2.0 events per year with placebo to about 1.4 with tozorakimab. Benefits were observed in former smokers, current smokers, and patients with low, intermediate, or high blood eosinophil counts.

Safety was generally comparable between groups. Any adverse event occurred in 70% to 80% of patients, and serious adverse events in 23% to 32%, with similar rates in the tozorakimab and placebo arms. Injection-site reactions were more common with active treatment.

“The results of this trial suggest an important new strategy for reducing the burden of COPD exacerbations,” co-lead author Frank C. Sciurba, MD, said in a statement.

Source: Sciurba FC, et al. (2026 Sep 8) N Engl J Med. Tozorakimab to Prevent COPD Exacerbations