Experimental drug cuts COPD flare-ups by 38% in Southampton-led trial

An experimental antibody drug cut the rate of serious flare-ups in people with chronic obstructive pulmonary disease by 38% over a year, in the largest UK-led trial of a new COPD treatment in a decade, researchers at the University of Southampton reported on Wednesday.

The trial, published in the Lancet Respiratory Medicine and presented at the European Respiratory Society congress in Vienna, enrolled 1,812 patients at 42 NHS hospitals who had suffered at least two flare-ups requiring steroids or admission in the previous year. Half received a monthly injection of tavrelimab, which blocks a protein called interleukin-33 that drives inflammation in the lungs; half received placebo. Both groups continued their usual inhalers.

Over 52 weeks, patients on the drug had an average of 0.71 moderate or severe exacerbations compared with 1.14 on placebo. Hospital admissions fell by 41%, and lung function measured by the volume of air exhaled in one second improved by an average of 86ml, a modest but statistically significant gain. Side-effects, chiefly injection-site reactions and a slightly higher rate of cold sores, were described as manageable.

“COPD kills 30,000 people a year in this country and we have had essentially the same drugs since the 1990s,” said Prof Martin Osei-Bonsu, the trial’s chief investigator and a consultant at Southampton General Hospital. “This is the first time we have seen a biological treatment move the needle on admissions, which is what patients fear and what fills our wards every winter.”

The benefit was concentrated in the roughly 60% of participants with raised levels of eosinophils, a type of white blood cell, in their blood at the start of the trial. In those with low counts the drug’s effect was not statistically significant, suggesting that a blood test would be needed to select patients.

COPD, which includes emphysema and chronic bronchitis and is mostly caused by smoking, affects about 1.7 million diagnosed people in the UK and an estimated 2 million more who do not know they have it. It is the second most common cause of emergency admission after heart disease.

The drug’s manufacturer, a Danish company, said it would apply for a UK licence early next year. Analysts expect a list price of around £9,000 a year, which would require the National Institute for Health and Care Excellence to weigh the cost against the £3,500 average cost of a COPD admission. Prof Osei-Bonsu said the economics were “likely to work for the sickest third of patients, and probably not for the rest”.

Carol Whitfield, 67, from Eastleigh, a former pub landlady who was admitted five times in 2024 and took part in the trial, said she had been in hospital once in the past year. “I do not know if I was on the drug or the dummy,” she said. “But I had Christmas at home for the first time in three years, and I would like to do that again.”