Tim Smith joined the MJH Life Sciences team in 2022 and is currently an associate editor for 

. He is also the executive producer of two podcasts: 

. Previously, he was the producer of the Lungcast podcast. He graduated from UC Berkeley and worked in multimedia journalism as a staff writer prior to joining MJH. You can contact him at tsmith@mjhlifesciences.com.

 experienced early and lasting improvements in itch, sleep, and quality of life with nemolizumab, according to new phase 2 data Galderma announced in October 2026.¹ The patient-reported outcomes, sustained through week 52, are being presented at the 2026 Pediatric Dermatology Research Alliance (PeDRA) Annual Conference.

Nemolizumab, marketed as Nemluvio in the US, is a monoclonal antibody that blocks signaling of interleukin (IL)-31, a neuroimmune cytokine implicated in itch, inflammation, epidermal dysregulation, and fibrosis. The 

 has approved the agent for adults with prurigo nodularis and for patients aged 12 years and older with moderate-to-severe atopic dermatitis, when used alongside topical corticosteroids and/or calcineurin inhibitors in disease not adequately controlled by topical prescription therapies. Its safety and efficacy have not yet been established in children younger than 12 years with atopic dermatitis.

How Was Nemolizumab Studied in Children Aged 2 - 11 Years?

The multicenter, open-label phase 2 trial assessed the pharmacokinetics, safety, and efficacy of nemolizumab use in pediatric patients with moderate-to-severe disease, along with patient-reported outcomes and quality-of-life measures. Investigators sorted participants into 3 cohorts by age and weight. Each child received weight-tiered nemolizumab dosing combined with topical therapy.

Lawrence F. Eichenfield, MD, professor of dermatology and pediatrics at the University of California, San Diego School of Medicine and chief of pediatric dermatology at Rady Children’s Hospital-San Diego, is the lead author of the abstract.

What Did the Phase 2 Results Show for Itch, Quality of Life, and Sleep?

Itch relief emerged early in treatment and persisted across the full year of follow-up. At week 16, between 56% and 72% of children across the 3 cohorts achieved at least a 4-point improvement on the Peak Pruritus Numerical Rating Scale, and response rates at week 52 were comparable or higher.

Sleep followed a similar trajectory. Scores on the Sleep Disturbance Numerical Rating Scale fell by 70% to 78% across cohorts at week 16, with additional gains recorded by week 52.

Quality-of-life outcomes also improved. Among children aged 4 years and older, mean Children’s Dermatology Life Quality Index scores declined from baseline by 10.7, 12.0, and 12.0 points across the cohorts at week 52. Improvements also appeared on age-specific instruments, including the Infants’ Dermatitis Quality of Life index for children younger than 4 years and the Patient-Oriented Eczema Measure for those aged 4 years and older.

Galderma reported nemolizumab was well tolerated in this younger population, with no new safety signals identified. The company noted the findings align with the established safety and efficacy profile of the agent in adolescents and adults with moderate-to-severe atopic dermatitis.

Why Do These Data Matter for Pediatric Atopic Dermatitis Care?

Atopic dermatitis affects up to 25% of children and is the most common inflammatory skin disease in this age group, with roughly one-third of affected children having moderate-to-severe disease. Persistent itch and recurrent lesions frequently interfere with sleep, school performance, and social confidence, and the burden extends to caregivers and families. Even so, approved systemic options for younger children with moderate-to-severe disease remain limited.

Eichenfield emphasized the considerable toll atopic dermatitis takes on children’s emotional well-being and daily functioning, and he pointed to an ongoing need for therapies capable of delivering meaningful benefit in this group. He described the sustained gains in itch, sleep, and quality of life over a single year as encouraging.

Christophe Piketty, MD, PhD, a study author and global program head for therapeutic dermatology at Galderma, described the results as adding to the existing clinical evidence for nemolizumab and supporting its potential implementation in a broader population, including young children.

Editor's Note: This summary has been edited for grammar and clarity using artificial intelligence tools.

Galderma. PeDRA 2026: Nemolizumab phase II data show long-term symptom relief for children aged 2 to 11 years with moderate-to-severe atopic dermatitis. Published October 15, 2026. Accessed October 17, 2026. 

https://www.galderma.com/news/pedra-2026-nemolizumab-phase-ii-data

Eichenfield LF, et al. Patient-reported outcomes and quality of life in pediatric patients (aged 2–11 years) with moderate-to-severe atopic dermatitis treated with nemolizumab. Presented at: Pediatric Dermatology Research Alliance (PeDRA) Annual Conference; October 15-17, 2026; United States.

Articles

Children aged 2 - 11 with atopic dermatitis saw early, lasting itch and sleep gains with nemolizumab through 1 year in phase 2 data shared at PeDRA 2026.

Atopic Dermatitis

Atopic Dermatitis condition center page, audiences can find a variety of coverage mediums for medical news and updates, including articles, video interviews, podcasts, and breaking news on dermatitis research, treatment, and drug development.

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Can Nemolizumab Help Children Under 12 with Moderate-to-Severe Eczema?

Chelsie Derman is an associate editor for 

who covers allergy and  psychiatry. She joined MJH Life Sciences in September 2023 after graduating from The College of New Jersey with a bachelor’s degree in journalism and professional writing. In her free time, she enjoys creative writing and reading.

Mepolizumab (Nucala) reduced total yearly systemic corticosteroid (SCS) exposure, particularly high-dose courses, in patients with

 and type 2 inflammation receiving inhaled triple therapy, according to pooled phase 3 data presented at the 

American College of Chest Physicians (CHEST) 2026 Annual Meeting

Although treatment guidelines recommend SCS for COPD exacerbations, these agents are associated with complications in this population, prompting interest in targeted therapies capable of limiting their use.¹ Mepolizumab, a humanized monoclonal antibody targeting interleukin-5 (IL-5), is approved for patients with COPD and an eosinophilic phenotype. The pooled analysis examined SCS use across blood eosinophil count (BEC) thresholds of ≥ 150 cells/µL and ≥300 cells/µL.¹

“Mepolizumab can serve as an add-on to inhaled triple therapy and may reduce SCS burden in COPD, particularly complications associated with short-term high-dose courses, across a wide spectrum of screening BEC levels,” said lead author Nicola Hanania, MD, director of the American Lung Association Airways Clinical Research Center (ACRC) at the Baylor College of Medicine, in a statement.²

Mepolizumab Effect on Systemic Corticosteroid Exposure in METREX, METREO, and MATINEE

Hanania and colleagues pooled data from 3 randomized, placebo-controlled phase 3 trials: METREX, METREO, and MATINEE.¹ Eligible patients were aged ≥ 40 years with a COPD diagnosis of ≥ 1 year, Global Initiative for Chronic Obstructive Lung Disease grade 2 to 4 airflow obstruction, a history of exacerbations, and no current asthma diagnosis. All patients were receiving inhaled triple therapy and received mepolizumab 100 mg subcutaneously or placebo every 4 weeks for 52 weeks (METREX, METREO) or up to 104 weeks (MATINEE).¹

METREX enrolled patients regardless of BEC, METREO required a screening BEC of ≥ 150 cells/µL (or ≥300 cells/µL in the prior year), and MATINEE required a screening BEC of ≥ 300 cells/µL (and ≥ 150 cells/µL in the prior year).¹ SCS doses were converted to prednisolone equivalents and stratified as low (< 20 mg/day) or high (≥ 20 mg/day).¹

Of 2089 patients enrolled (1043 mepolizumab, 1046 placebo), 1713 had a BEC of ≥ 150 cells/µL and 1144 had a BEC of ≥300 cells/µL.¹ In the ≥ 150 cells/µL group, mean total SCS exposure was 434.64 mg/year with mepolizumab vs 609.95 mg/year with placebo (mean difference, 178.97 mg/year; 95% CI, 62.09–292.19).¹ In the ≥300 cells/µL group, mean exposure was 354.28 mg/year vs 551.52 mg/year, respectively (mean difference, 193.58 mg/year; 95% CI, 84.01–306.80).¹

Mepolizumab and High-Dose Systemic Corticosteroid Courses in COPD

Mepolizumab reduced mean total yearly SCS exposure vs placebo in patients with COPD and type 2 inflammation receiving inhaled triple therapy (434.64 vs. 609.95 mg/year at BEC ≥150 cells/µL).

The reduction was driven by high-dose courses, with low-dose SCS days similar between arms.

Benefit was observed at both the ≥150 cells/µL and ≥300 cells/µL BEC thresholds across 2089 pooled patients.

Among patients with a BEC of ≥ 150 cells/µL, 57% received SCS for any cause, as did 55% of those with a BEC of ≥ 300 cells/µL.¹ The mean percentage of days not receiving SCS was 89.8% with mepolizumab vs 88.3% with placebo in the ≥150 cells/µL group and 90.8% vs 88.9% in the ≥300 cells/µL group.¹

The between-group difference centered on high-dose courses. In the ≥ 150 cells/µL group, the mean percentage of days on high-dose SCS was 4.5% with mepolizumab vs 5.9% with placebo, and low-dose days were identical at 5.7% in both arms.¹ In the ≥300 cells/µL group, high-dose days were 3.8% vs 5.1%, and low-dose days were 5.4% vs 6.1%.¹

Investigators concluded mepolizumab reduced total yearly SCS exposure compared with placebo regardless of whether patients met the ≥150 cells/µL or ≥300 cells/µL screening threshold.

Full results will be presented in the Precision COPD: Type 2 Inflammation, Biomarkers, and Targeted Therapy rapid fire original investigation session at CHEST 2026 on Tuesday, October 20, from 1:45 pm to 2:30 pm MST.²

Hanania NA, Kraft M, Burrows E, et al. Mepolizumab reduces systemic corticosteroid utilization in COPD with type 2 inflammation: pooled results from phase 3 randomized trials. 

Mepolizumab reduces systemic corticosteroid exposure in patients with COPD and type 2 inflammation. American College of Chest Physicians. Published October 12, 2026. Accessed October 18, 2026. 

https://www.chestnet.org/-/media/documents/news/03-mepolizumab-reduces-systemic-corticosteroid-exposure-in-patients-with-copd-and-type-2-inflammation.ashx

In pooled phase 3 data, mepolizumab lowered mean yearly systemic corticosteroid exposure by 178.97 mg in patients with a BEC of ≥150 cells/µL.

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Mepolizumab Reduces Systemic Corticosteroid Exposure in Eosinophilic COPD

Empiric chronic proton pump inhibitor (PPI) use was associated with more 

 exacerbations, rescue systemic corticosteroid use, and respiratory infections in adults with biologic-treated, difficult-to-treat asthma, according to data presented at the 

“Clinicians should carefully reassess the necessity of chronic PPI therapy in biologic-treated asthma patients without clear ulcer-related indications,” said investigator Joshua Le, MD, a resident physician at Allegheny Health Network.² “Chronic PPI use frequently persists as an act of omission, with therapy continued beyond its initial short-term indication despite resolution of symptoms or lack of objective need.”

PPIs have shown modest benefit in a small subset of patients with asthma, particularly those with nocturnal symptoms and coexisting reflux.¹ A growing body of evidence links long-term PPI exposure to infectious and systemic adverse events.¹ However, data in patients receiving empiric therapy without ulcer-related indications remain limited, especially among those treated with biologics.¹

Chronic PPI Use and Asthma Exacerbations in Biologic-Treated Patients

Le and colleagues conducted a retrospective propensity score–matched cohort study using the TriNetX US Collaborative Network, which includes 65 health care organizations.¹ The analysis included adults aged ≥ 18 years with asthma treated between 2014 and 2025 with omalizumab, mepolizumab, benralizumab, reslizumab, dupilumab, or tezepelumab. Investigators excluded patients with gastroesophageal reflux disease, eosinophilic esophagitis, Barrett esophagus, peptic ulcer disease, or esophageal varices to isolate empiric PPI use.¹

Persistent exposure was defined by repeated PPI prescriptions at 3 to 6 months and 6 to 12 months. PPI users were older (mean, 58.3 vs 48.1 years) and carried a greater burden of hypertension (21.1% vs 13.9%) and diabetes (10.8% vs 5.3%).¹

Matching (1:1) on 105 covariates balanced demographics, comorbidities, asthma severity markers, prior exacerbations, medication exposure, IgE, eosinophils, body mass index, and health care utilization.¹ After matching, 1228 patients remained in each cohort, with outcomes assessed from 1 to 365 days after the index prescription. During 1 year of follow-up, asthma exacerbations occurred in 31.9% of PPI users vs 22.6% of nonusers (OR, 1.60; 95% CI, 1.34–1.92; 

Corticosteroid Exposure, Respiratory Infections, and Health Care Utilization

Empiric chronic PPI use was associated with more asthma exacerbations (31.9% vs 22.6%; OR, 1.60) in 1228 matched pairs of biologic-treated patients.

Rescue systemic corticosteroid use (OR, 3.88), respiratory infections (OR, 3.83), and intensive care unit admissions (OR, 3.65) were also more frequent among PPI users.

Investigators call for structured deprescribing of PPIs lacking a clear ulcer-related indication in this population.

Rescue systemic corticosteroid use was nearly twice as common among PPI users (72% vs 40%; OR, 3.88; 95% CI, 3.27–4.59; 

 <.0001).¹ Respiratory infections occurred in 8.4% of PPI users compared with 2.3% of nonusers (OR, 3.83; 95% CI, 2.52–5.82; 

Chronic PPI use was also associated with more intensive care unit admissions (4.3% vs 1.2%; OR, 3.65; 95% CI, 2.04–6.50; 

 <.0001) and emergency department visits (15.6% vs 8.4%; OR, 2.00; 95% CI, 1.56–2.58; 

 <.0001).¹ All-cause mortality did not differ significantly between groups.¹

Investigators concluded long-term acid suppression may represent a modifiable risk factor in this population. They noted the association may be mediated by microbiome alteration and increased susceptibility to respiratory pathogens.¹

“Proactive medication reconciliation, clear documentation of indication, and structured deprescribing strategies may reduce unnecessary long-term exposure and help mitigate preventable morbidity in this vulnerable population,” Le said.²

Le JP, Gupta N, Malode A, et al. Empiric chronic proton pump inhibitor use is associated with increased exacerbations in biologic-treated difficult-to-treat asthma: a propensity-matched US cohort study. 

https://doi.org/10.1016/j.chest.2026.07.3902 

Chronic proton pump inhibitor use associated with increased exacerbations in biologic-treated asthma. American College of Chest Physicians. Published October 12, 2026. Accessed October 18, 2026. 

https://www.chestnet.org/-/media/documents/news/02-empiric-chronic-proton-pump-inhibitor-use-is-associated-with-increased-exacerbations-in-biologictreated-difficulttotreat-asthma-a-propensity-matche.ashx

Chronic proton pump inhibitor use carried 60% greater odds of asthma exacerbation and nearly 4-fold odds of rescue corticosteroid use in a matched cohort of 2456 patients.

Asthma

The HCPLive asthma page is a comprehensive resource for clinical news and insights on asthmatic disease. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for allergic and severe asthma, and more.

Chronic Proton Pump Inhibitor Use Linked to More Asthma Exacerbations 

Mathew Maurer, MD, is the Arnold and Arlene Goldstein Professor of Cardiology at Columbia University Irving Medical Center, Vagelos College of Physicians & Surgeons.

I-124 evuzamitide positron emission tomography (PET)/computed tomography (CT) scans are highly sensitive and specific for detecting cardiac amyloidosis, according to results from the REVEAL study.

I-124 Evuzamitide PET/CT Highly Sensitive, Specific in Amyloid Detection

Heart Failure Society of America (HFSA) Annual Scientific Meeting 2026

 in Phoenix, Arizona, by Mathew Maurer, MD, the Arnold and Arlene Goldstein Professor of Cardiology at Columbia University Irving Medical Center, Vagelos College of Physicians & Surgeons.

“We think that this could be a very useful way to not only diagnose amyloid but diagnose it in a more sensitive and potentially more specific manner than currently available imaging,” Maurer told 

 in an exclusive interview. “And, importantly, at a time when the patient doesn’t have advanced cardiac amyloid, when drug therapy is most effective.”

REVEAL was a phase 3, open-label, multicenter study of I-124 evuzamitide as an imaging agent to diagnose cardiac amyloidosis. Patients were eligible for enrollment if they were suspected of having cardiac amyloidosis and were or would be undergoing a diagnostic evaluation for cardiac amyloidosis, among other criteria. Patients were excluded if they had an already established diagnosis of cardiac amyloidosis, were receiving therapy for amyloid transthyretin (ATTR) cardiac amyloidosis at enrollment, or had a myocardial infarction within 3 months of screening, among other criteria.

Patients were administered a single dose of I-124 evuzamitide, which was administered intravenously. This was followed by oral potassium iodide for 3 days and a safety follow-up of 5 +/-2 and 30 +/- 5 days, at which point clinicians conducted safety blood tests. Standard-of-care tests were then undertaken up to day 60. The trial’s primary endpoint was the sensitivity and specificity of PET/CT images based on visual scan interpretation versus adjudicated diagnosis. The secondary endpoint was sensitivity and specificity by amyloid subtype.

After taking PET/CT scans, the resulting images were de-identified and interpreted by 3 physicians with extensive experience, looking for the visual presence or absence of I-124 evuzamitide uptake. The standard-of-care diagnostic evaluations were interpreted by 3 amyloid expert physicians to determine diagnosis of cardiac amyloidosis based on current guideline recommendations. Both groups were blind to clinical data.

A total of 195 patients were ultimately enrolled in the trial, of whom 170 received evuzamitide. Among these 170 patients, average NT-proBNP was 471 ng/L, while average LV wall thickness was 13 mm and LV ejection fraction was 57%. Additionally, 54 patients were confirmed to have ATTR, 21 had amyloid light-chain (AL), and 93 had no cardiac amyloidosis.

Maurer and colleagues ultimately recorded an overall sensitivity of 93.5% (95% CI, 85.5-97.9; 

 <.0001) and a specificity of 86% (95% CI, 77.3-92.3; 

 <.0001) with I-124 evuzamitide. The negative prediction value was 94.1% (95% CI, 86.8-98.1) and the positive prediction value was 84.7%. Sensitivity was comparable among patients with ATTR (96.3%, 52 of 54) and AL (95.2%, 20 of 21). Additionally, evuzamitide PET outperformed bone scintigraphy in early ATTR, primarily in early, low-burden ATTR; 44% of PET-detected adjudicated ATTR had low natriuretic peptides or normal wall thickness, and 8 patients who were equivocal or negative on bone scintigraphy were detected by evuzamitide PET.

Ultimately, Maurer and colleagues concluded that these data reflect evuzamitide PET scanning’s capacity to streamline 

 amyloid evaluation and to identify early ATTR currently missed by imaging. While Maurer cites a handful of limitations inherent in the study’s structure, he is optimistic about the potential of this novel scanning technology.

“We’re at a tipping point here where we can identify amyloid early,” Maurer said. “Amyloid is not pathologically normal, so it’s never normal to have amyloid in an organ, and as a result, we’ve been talking about earlier diagnosis for years, if not decades. This particular scanning technique could provide a real opportunity to improve outcomes for patients.”

Editors’ Note: Maurer reports disclosures with Alnylam, AstraZeneca, Bridge Bio, Ionis, Novo Nordisk, Pfizer, and others.

Maurer M, Masri A, Ezzeddine O, et al. 124I-Evuzamitide Amyloid-Targeted PET/CT: Detection of Early Cardiac Amyloidosis in a Prospective Multicenter Phase 3 Study Cohort. Presented at the Heart Failure Society of America (HFSA) Annual Scientific Meeting 2026, Phoenix, AZ. October 9-12, 2026.

Sharmila Dorbala, Brigham and Women’s Hospital. REVEAL - Research With I-124 EVuzamitide to Elucidate Cardiac AmyLoidosis (REVEAL). ClinicalTrials.gov Identifier: NCT06788535. Updated April 30, 2026. Accessed October 16, 2026. 

https://clinicaltrials.gov/study/NCT06788535?term=NCT06788535&rank=1

Videos

Mathew Maurer, MD, discusses the results of the phase 3 REVEAL study, which highlighted this novel scanning technology’s capacity for identifying amyloidosis early.

Cardiology

Cardiology condition center page is a comprehensive resource for clinical news and insights on cardiovascular and cardiometabolic diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for heart disease and cardiovascular events, as well as associated diabetes, renal failure, and more...

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Associate Professor of Medicine, Harvard Medical School

Associate Physician, Brigham and Women's Hospital

Mucus plugging is increasingly recognized as a pathophysiological feature of 

chronic obstructive pulmonary disease (COPD)

, associated in prior literature with worse symptoms, poorer quality of life, higher exacerbation risk, and increased mortality. A late-breaking integrated analysis of the replicate phase 3 OBERON and TITANIA trials introduced a segmental mucus plug score, a standardized metric scoring 18 lung segments for the presence or absence of a plug using a centralized double-read CT paradigm.

Nearly 79% of the imaging cohort had at least 1 mucus-plugged segment at baseline, and these patients had worse lung function, higher symptom burden, and more prior exacerbations than those without plugging. Tozorakimab produced a dose-dependent reduction in segmental mucus plug score at week 52, with both current and former smokers contributing to the overall effect. The finding is consistent with the earlier FRONTIER-4 CT substudy, making tozorakimab the first biologic shown to significantly reduce mucus plugging in a broad COPD population.

Tozorakimab is a monoclonal antibody inhibiting both the reduced and oxidized forms of interleukin-33, a dual mechanism the investigators say offers a biologically coherent explanation for effects on mucus dysfunction alongside inflammation. The mucus-plug finding is exploratory and was not adjusted for multiplicity, but it sits alongside the primary result from OBERON and TITANIA, where tozorakimab reduced moderate or severe exacerbations, including those requiring hospitalization or emergency care, by approximately 30% compared with placebo across 2 replicate phase 3 trials.

George Washko, MD, associate professor of medicine at Harvard Medical School and a co-author on the integrated mucus-plug analysis, spoke with 

ERS Congress 2026 held in Barcelona in September

 . In the following interview, Washko discusses what the segmental mucus plug score adds to the clinical picture of tozorakimab in COPD.

HCPLive: Why is the new segmental mucus plug score an important measure, and how does it compare with prior COPD imaging assessments?

The segmental mucus plug score gives us a standardized, quantitative way to assess mucus plugging across the lung. Each of 18 lung segments is assessed for the presence or absence of a mucus plug, producing a score from 0 to 18. This allows us to measure not only how much of the lung is affected by mucus plugging, but importantly, whether that burden changes with treatment over time. This is clinically relevant because mucus plugging is increasingly recognized as an important pathophysiological feature of COPD and has been associated with worse symptoms, poorer quality of life, increased exacerbation risk, and higher mortality. Prior CT studies helped establish those associations. What this analysis adds is a longitudinal assessment within a randomized phase 3 program, the first to show a biologic treatment, tozorakimab, can significantly reduce mucus plugging in a broad COPD population, measured at week 52. The finding is also consistent with the earlier FRONTIER-4 CT substudy, which showed a reduction in segmental mucus plug score with tozorakimab versus placebo.

HCPLive: Does mucus plugging mark a distinct, more severe COPD phenotype, or simply general disease severity?

The most important finding is that mucus plugging identified a group of patients with greater clinical disease burden. Nearly 80% of evaluable patients had at least one mucus plug at baseline, and those with mucus plugging had worse lung function, poorer quality of life, and a greater exacerbation burden than patients without mucus plugs. So mucus plugging appears to be an important imaging feature of clinically more burdensome COPD. Whether it represents a completely distinct biological phenotype independent of other measures of disease severity is a separate question, but these results reinforce that mucus plugging is not simply an incidental CT finding.

HCPLive: The mucus-plugging reduction appeared numerically larger in current smokers than former smokers. How should this be interpreted given the smaller sample?

The most robust finding is the significant reduction in mucus plug burden in the overall population, together with a dose-dependent reduction in segmental mucus plug score. The numerical finding in current smokers is interesting, however the current smoker group was a small subgroup of the overall population and therefore difficult to interpret in isolation. It is important to note that a reduction in mucus plugs was noted in both the smoker and former smoker population, with both populations contributing to the overall effect seen with tozorakimab.

HCPLive: As an exploratory endpoint without multiplicity adjustment, what weight should this finding carry alongside the primary exacerbation results?

Reducing exacerbations is a key aim for COPD treatment, as they are the most clinically meaningful events that drive disease trajectory, patient survival, and economic burden in COPD. For that reason, the most important finding is that these trials represent the first phase 3 evidence of a biologic demonstrating clinically meaningful reductions in COPD exacerbations across this broad COPD population. The mucus-plug analysis is exploratory, but it adds important biological context to the clinical efficacy results. Tozorakimab significantly reduced a CT-defined airway abnormality associated with worse COPD outcomes, and the finding is consistent with the earlier FRONTIER-4 CT substudy. The mucus data can be interpreted as complementary evidence: they strengthen the overall picture that tozorakimab is affecting both clinically meaningful exacerbations and an airway process relevant to COPD pathophysiology.

HCPLive: Is tozorakimab the first biologic to reduce mucus plugging due to a data gap, or does IL-33 blockade act on mucus specifically?

What we can say is that tozorakimab is the first biologic shown to significantly reduce mucus plugging in a broad COPD population, and there is a strong biological rationale for that effect. IL-33 sits upstream of several processes relevant to COPD. More specifically, tozorakimab uniquely inhibits IL-33 signaling in two ways: suppressing inflammation and disrupting the cycle of mucus dysfunction. This provides a biologically coherent explanation for why we would see an effect on mucus dysfunction as well as exacerbations.

HCPLive: If this mucus-plug reduction holds up, what needs to be shown next to confirm it translates into harder clinical outcomes?

What is encouraging is that the mucus-plug finding is not occurring in isolation. Higher mucus plug scores have been associated with increased exacerbation risk, accelerated lung function decline, and increased all-cause mortality. At the same time, the OBERON and TITANIA program showed that tozorakimab significantly reduced mucus plugging and also reduced moderate or severe COPD exacerbations by approximately 30% in two replicate phase 3 trials. We also saw reductions in more consequential events, including exacerbations requiring hospitalization or emergency department care. That convergence is important: the imaging effect is occurring alongside demonstrated clinical efficacy, rather than as an isolated radiographic finding.

Editor's Note: This Q&A has been lightly edited for clarity. Washko’s disclosures include Sanofi and Regeneron.

Washko G, Sciurba F, Watz H, et al. Tozorakimab reduces the number of lung segments with mucus plugs in patients with COPD at high risk of exacerbations: integrated analysis of the replicate OBERON and TITANIA phase 3 studies [late-breaking abstract]. Presented at: ERS Congress 2026; September 5-9, 2026; Barcelona, Spain.

Singh D, Guller P, Reid F, et al. A phase 2a trial of the IL-33 mAb tozorakimab in patients with COPD: FRONTIER-4. Eur Respir J. 2025;66(1):2402231.

Sciurba FC, Watz H, Bourdin A, et al. Tozorakimab to prevent COPD exacerbations. N Engl J Med. 2026. doi:10.1056/NEJMoa2606998

George Washko, MD, discusses a late-breaking OBERON/TITANIA analysis showing tozorakimab reduces segmental mucus plug scores in COPD.

Tozorakimab Cuts COPD Mucus Plugging, With George Washko, MD

Victoria Johnson joined MJH Life Sciences in 2020 and has written for NeurologyLive, CGTLive, and is now an assistant managing editor for HCPLive and RheumatologyLive. She doesn’t have enough time for her various hobbies. You can reach her at vjohnson@mjhlifesciences.com.

Advanced practice providers described how documentation, specialty pharmacy support, and payer requirements shape biologic selection and timing.

Biologic Access in Asthma and COPD: Clinical Forum Perspectives

Participants said payer criteria and patient goals often outweigh mechanism when choosing biologics, and that shared decision-making is harder in COPD.

Treatable Traits in Asthma and COPD: Clinical Forum Perspectives

Jennifer Vittorio, MD, associate professor of pediatrics and medical director of pediatric liver transplantation at NYU Langone Health

Jennifer Vittorio, MD, discusses EXPAND pruritus and serum bile acid results, the ItchRO(Obs) endpoint, and implications for biliary atresia.

Hepatology

Maralixibat Reduces Cholestatic Pruritus in Phase 3 EXPAND, With Jennifer Vittorio, MD

Chirag Patel, MD, chief of allergy and immunology at Hackensack Meridian Jersey Shore University Medical Center,

Chirag Patel, MD, explains why reaction timing, isolated abdominal pain, and careful test interpretation are central to recognizing alpha-gal syndrome.

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Allergy condition center page is a comprehensive resource for clinical news and insights on allergic and inflammatory diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for food and seasonal allergies, as well as allergic asthma and related conditions.

Strategic Alliance Partnership

Alpha-Gal Syndrome Clues Clinicians Miss, With Chirag Patel, MD

Quin Denfeld, PhD, is an associate professor at Oregon Health & Science University.

Quin Denfeld, PhD, discusses her findings from the BIOMES-HF study, indicating worsening symptoms in patients with HF over time.

Dyspnea Worsens in 1 in 3 Patients Following Discharge from HF Hospitalization

Jennifer Vittorio, MD, of NYU Langone, explains how itch presents from infancy to adolescence and why off-label options fell short.

Cholestatic Pruritus in Children: Signs, Burden, and Treatment Gaps

Ryan Livingston joined the MJH Life Sciences team in March of 2025, shortly after graduating from TCNJ with a bachelor’s degree in English. He enjoys creative writing, reading, and scuba diving. He can be reached at rlivingston@mjhlifesciences.com.

A single Revita procedure preserved about 80% of tirzepatide-induced weight loss at six months in the REMAIN-1 pivotal cohort.

Endocrinology

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This page also hosts content previously published by EndocrinologyNetwork. 


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Revita Reduces Weight Regain After GLP-1 Discontinuation in REMAIN-1

Diana Isaacs, PharmD, is an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic.

Podcasts

Diana Isaacs, PharmD, and Natalie Bellini, DNP, discuss a major breakthrough with the Twiist insulin pump and the recent ADA/EASD T2D guidelines.

Type 2 Diabetes

podcasts page features a feed of medical news and interview podcast series, including DocTalk, Lungcast, Derm Discussions, and Heart Trials.

Diabetes Dialogue

Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives is a podcast hosted by Diana Isaacs, PharmD, and Natalie Bellini, DNP, aimed at providing a regular roundup of the latest clinically applicable insights across diabetes and metabolic diseases, with a focus on leveraging technology to improve care.

Diabetes Dialogue: Twiist AID Data and the New ADA/EASD Type 2 Algorithm

David Cotter, MD, PhD, explains how remibrutinib's approval for symptomatic dermographism changes treatment sequencing in chronic urticaria.

Urticaria

The HCPLive urticaria page is a comprehensive resource for clinical news and insights on chronic idiopathic urticaria and chronic spontaneous urticaria. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for urticaria, and more.

Dermatology

The HCPLive dermatology page is a resource for medical news and expert insights on skin disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for dermatologic conditions, and more.

Remibrutinib and the First On-Label Option for Symptomatic Dermographism, With David Cotter, MD, PhD

Ronnie Fass, MD, is the Medical Director of the Digestive Health Center, Chairman of the Division of Gastroenterology and Hepatology, and head of the Esophageal and Swallowing Program at the MetroHealth Medical Center. He is also a tenured professor of medicine at Case Western Reserve University.

Ronnie Fass, MD, discusses phase 3 TRIUMpH-NERD data showing tegoprazan increased heartburn-free and regurgitation-free days vs placebo in NERD.

Gastroenterology

Gastroenterology condition center page is a comprehensive resource for clinical news and insights on digestive and GI conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for 

, IBS and IBD, Crohn's disease, and more.

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I-124 Evuzamitide PET/CT Highly Sensitive, Specific in Amyloid Detection

Tozorakimab Cuts COPD Mucus Plugging, With George Washko, MD