AstraZeneca and Sanofi unveil top results in respiratory medicine

Pharma News: The latest research from AstraZeneca and Sanofi on chronic obstructive pulmonary disease (COPD) treatments was unveiled at the American Thoracic Society’s (ATS) International Conference held 19 – 24 May.

AstraZeneca’s EROS real-world study, the first of its kind, examined the effects of initiating fixed-dose triple-combination therapy Breztri Aerosphere within 30 days of a moderate or severe COPD exacerbation. The results were staggering – patients who started treatment early experienced a remarkable 24% reduction in the risk of future exacerbations compared to those who delayed treatment by one to six months. Moreover, the risk dropped by an astonishing 34% for patients who delayed treatment for six months to a year. These findings highlight the critical importance of timely intervention to prevent exacerbations that could lead to hospitalization or even death.

Dr Charlie Strange, an investigator in the EROS study, emphasised the significance of these results.

“COPD exacerbations pose a significant threat to patients, increasing their risk of future exacerbations and other severe complications. The EROS data reinforce the growing body of evidence that Breztri is highly effective in reducing COPD exacerbation rates and can significantly mitigate the risk of future exacerbations when administered promptly,” he stated.

In additional data from AstraZeneca, the EXACOS-CV retrospective cohort analysis examined the link between COPD exacerbations and acute cardiovascular events. Shockingly, researchers found that the risk of a severe cardiovascular event, including stroke, heart failure, pulmonary embolism, arrhythmia, or heart attack, increased by 32% in the first 30 days following a moderate or severe exacerbation. The risk remained elevated for one year, with each subsequent exacerbation amplifying the risk of acute cardiovascular events even further (more than a twofold increase in risk following two or three exacerbations). These findings underscore the need to consider COPD patients, even those newly diagnosed, at risk of cardiopulmonary events following exacerbations.

Commenting on the significance of these results, Robert Fogel, Vice President of Global Medical Affairs at AstraZeneca, emphasised the urgency of improving outcomes for COPD patients. As the third leading cause of death worldwide, COPD demands immediate attention from healthcare professionals and health systems. The EROS and EXACOS-CV studies not only enhance our understanding of the cardiopulmonary risks associated with COPD but also highlight the opportunity to reduce exacerbations through proactive treatment with Breztri.

In addition to these studies, the ATS 2023 Conference also featured positive Phase 3 results from Regeneron and Sanofi, evaluating the use of Dupixent (dupilumab) in COPD patients with uncontrolled chronic inflammation despite being on standard-of-care inhaled triple therapy. The results demonstrated a remarkable 30% reduction in moderate or severe acute COPD exacerbations over 52 weeks compared to placebo. Furthermore, lung function showed a significant improvement of 160 mL from baseline at 12 weeks, compared to only 77 mL for the placebo group.

Notably, a pre-specified analysis focusing on patients with elevated levels of fractional exhaled nitric oxide (FeNO), an airway biomarker of type 2 inflammation, revealed even more promising results. In this subgroup, Dupixent treatment led to a significant 38% reduction in exacerbations compared to placebo at 52 weeks, along with a sustained improvement in lung function.

Co-principal investigator of the trial, Dr Surya Bhatt, shared his excitement about the potential impact of Dupixent on COPD patients with type 2 inflammation. He emphasised that this trial has the potential to break the vicious cycle of exacerbations and lung function decline, significantly improving respiratory symptoms and quality of life for patients who have struggled with uncontrolled COPD for a long time.

The ATS 2023 Conference has undoubtedly been a turning point in the understanding and treatment of COPD, offering hope for millions of patients worldwide.

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