AstraZeneca reports positive Phase III MIRANDA results showing tozorakimab significantly reduced COPD exacerbations, supporting its potential as a first-in-class IL-33–targeting biologic.
Written By: Nikita Jha, BPharm
Reviewed By: Pharmacally Editorial Team
On April 21, 2026, AstraZeneca announced high-level results from the Phase III MIRANDA trial (NCT06040086), demonstrating that tozorakimab achieved a statistically significant and clinically meaningful reduction in the annualized rate of moderate-to-severe exacerbations in patients with chronic obstructive pulmonary disease (COPD).
The benefit was observed in the primary population of former smokers as well as in the overall study population, which included both former and current smokers across all blood eosinophil levels and stages of lung function impairment.
In the trial, patients who continued to experience exacerbations despite standard inhaled therapies were randomized to receive tozorakimab 300 mg or placebo every two weeks, alongside standard of care, over 52 weeks. These findings are consistent with results from the OBERON and TITANIA trials, which evaluated a four-week dosing regimen.
Tozorakimab targets interleukin-33 (IL-33), an upstream regulator of inflammation in COPD, and inhibits both its reduced and oxidized forms to reduce inflammation and disrupt mucus dysfunction associated with disease progression. The therapy was generally well tolerated, with a safety profile consistent with previous studies. Detailed data are expected to be shared with regulators and presented at upcoming scientific meetings.
Frank Sciurba, Chief Investigator of the LUNA programme, stated that the findings add to growing evidence of clinical benefit, particularly given that many patients continue to experience exacerbations despite current treatments.
Sharon Barr, Executive Vice President of BioPharmaceuticals R&D at AstraZeneca, emphasized the potential of tozorakimab as a first-in-class biologic with a differentiated mechanism targeting IL-33 signalling, and confirmed plans for regulatory engagement.
COPD affects nearly 400 million people globally and is the third leading cause of death. More than half of patients continue to experience exacerbations despite standard therapies, increasing the risk of hospitalization and mortality. Tozorakimab is being further evaluated in the broader LUNA development programme, as well as in additional indications including severe viral lower respiratory tract disease and asthma.
Reference
Tozorakimab met primary endpoint in Phase III MIRANDA trial in patients with COPD
About the Writer
Nikita Jha, BPharm a pharmacy graduate specializing in medical writing, with a strong ability to interpret complex medical and regulatory information and translate it into clear, accurate, and evidence-based healthcare content. Known for her attention to detail and precision, she focuses on delivering high-quality scientific communication that supports drug safety and informed decision-making.