AstraZeneca PLCAZN
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AstraZeneca PLC Investor update

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Operator

Welcome, ladies and gentlemen, to AstraZeneca's Meet the Management event at the ERS Congress 2026 in Barcelona. Before I hand over to AstraZeneca, I would like to read the safe harbor statement. The company intends to utilize the safe harbor provisions of the United States Private Securities Litigation Reform Act of 1995. Participants on this call may make forward-looking statements with respect to the operations and financial performance of AstraZeneca. Although we believe our expectations are based on reasonable assumptions, by their very nature, forward-looking statements involve risks and uncertainties and may be influenced by factors that could cause actual results to differ materially from those expressed or implied by these forward-looking statements. Any forward-looking statements made on this call reflect the knowledge and information available at the time of this call. The company undertakes no obligation to update forward-looking statements.

Operator

Please also carefully review the forward-looking statement disclaimer in the slide deck that accompanies this presentation and webinar. There will be an opportunity to ask questions after today's presentations. Please use the raise a hand feature to indicate you wish to ask a question, and remember to unmute your line when invited to speak. Now with that, I will now hand you over to the company.

Ruud DobberEVP of BioPharmaceuticals Business Unit

Thank you so much, operator. Good morning, good afternoon, good evening, everyone. My name is Ruud Dobber. I am the Executive Vice President for the BioPharmaceuticals Business at AstraZeneca. I would welcome you and thank you for joining us to hear about the phase III OBERON and TITANIA data for tozoracimab in COPD, presented earlier today here at the 2026 European Respiratory Society Congress in Barcelona. As always, the materials presented today will be published on the AstraZeneca Investor Relations website following this presentation. Next slide, please. Here are our usual forward-looking statements, which I encourage you to read. Next slide, please. This is our agenda for today's call. We are delighted to be joined by Dr. Frank Sciurba, Professor of Pulmonary and Critical Care Medicine at the University of Pittsburgh, who will walk us through the exciting phase III OBERON and TITANIA data presented earlier today at the ERS.

Ruud DobberEVP of BioPharmaceuticals Business Unit

Next slide, please. Before we go into the data, let's take a step back and look at the role of R&I in delivering our AstraZeneca ambition in 2030 and beyond. Next slide, please. Many of you will recall that our Investor Day in May 2024, we set out our $80 billion risk-adjusted total revenue ambition for 2030. Since then, we have delivered strong commercial execution and substantial pipeline progress, further strengthening our confidence in the growth trajectory through 2030 and beyond. Respiratory and Immunology is an important contributor to that growth. Alongside the rapidly growing existing brands in our inhaled and biologics portfolio, tozoracimab is one of the key new medicines we expect to launch this decade, and we look forward to discussing its potential with you today.

Ruud DobberEVP of BioPharmaceuticals Business Unit

In addition to the tozoracimab data, we have a number of upcoming catalysts for high-value assets across biopharma, oncology, and rare disease, which reinforce the breadth and durability of our long-term growth outlook. Next slide, please. Turning specifically to our respiratory and immunology portfolio, we have key inhaled and biologic medicines across asthma and COPD. Five recently launched brands have all delivered double-digit growth so far in 2026. We expect further momentum from the recent launch of BREZTRI in asthma and from the expansion of Tezspire and FASENRA in China and Japan. We also have ongoing lifecycle management programs for a number of these assets.

Ruud DobberEVP of BioPharmaceuticals Business Unit

For example, we recently announced positive high-level results for the CROSSING Phase III trial in eosinophilic esophagitis, where Tezspire demonstrated clinically meaningful and statistically significant improvements across both co-primary and all key secondary endpoints, opening the door for Tezspire to potentially improve the lives of patients with this disease. Our R&I portfolio also has five NMEs in Phase II that will drive future growth, including our inhaled TSLP in asthma and other assets being studied in COPD, rheumatoid arthritis, Crohn's disease, and idiopathic pulmonary fibrosis. Taken together, this rapidly evolving portfolio and pipeline will fuel future growth for the business to 2030 and beyond. With that, let me hand over to Sharon to talk about how we are positioned to address the needs across asthma and COPD. Next slide, please, and over to you, Sharon.

Sharon BarrEVP of BioPharmaceuticals R&D

Thanks, Ruud. As shown here, our respiratory portfolio spans the full spectrum of asthma and COPD care, from primary care-led inhaled therapies through to specialty care-led biologics as patients' treatment needs evolve. In asthma, we already have a strong inhaled presence with SYMBICORT, AIRSUPRA, and recently approved in the U.S. and Japan, BREZTRI, which is the first and only triple therapy approved in asthma for patients 12 years of age and older. Today, as patients continue to progress, they can move to our approved biologics, FASENRA and Tezspire. We also have sonacamtumab, our inhaled TSLP, which recently read out its Phase II-B study. This is the first-ever inhaled biologic in asthma that is being explored to potentially reach a significant number of patients who today are uncontrolled on inhaled standard of care and don't have access to a biologic.

Sharon BarrEVP of BioPharmaceuticals R&D

In COPD, we have the potential to extend our inhaled portfolio beyond BREZTRI and SYMBICORT with TQC2731, the inhaled PDE3/4 inhibitor for which we announced a licensing agreement in July. Similar to asthma, we are developing multiple therapeutic options to address the high unmet need in COPD. Specifically, in addition to tozoracimab, we also have Tezspire in Phase III and our oral IRAK4 inhibitor, AZD6793, in Phase II, one of the five NMEs that Ruud alluded to earlier. This is a respiratory portfolio purposefully built to meet patients, no matter their disease severity or whether they are being treated in a primary or a specialty care setting. Next slide, please. COPD remains one of the greatest areas of unmet need in respiratory disease. Nearly 40 million patients are on inhaled maintenance therapy.

Sharon BarrEVP of BioPharmaceuticals R&D

Of those maintenance patients who are on optimized standard of care, meaning dual or triple therapy, half still experience exacerbations, and these exacerbations matter enormously. COPD is the third leading cause of death globally. One in 2 patients die within 3 and a half years of their first severe exacerbation. That is a worse survival rate than a heart attack. Beyond the human toll, the cost to global health systems from COPD is expected to reach $4 trillion by 2050, driven in part by the high costs of these severe lung attacks. Preventing exacerbations is therefore a critical goal in the treatment of COPD, both to improve patient outcomes and to reduce the burden on healthcare systems. With that, I will hand over to Dr. Sciurba, who will take you through the exciting phase III OBERON and TITANIA data for tozoracimab.

Frank SciurbaProfessor of Pulmonary and Critical Care Medicine

Thank you, Sharon. I am going to quickly present the data that I presented at the European Respiratory Society today on tozoracimab phase III studies, OBERON and TITANIA, in the prevention of exacerbations in patients with COPD. Next slide, please. Basically, what Sharon said is that COPD exacerbations are really important events in the life of patients. That first event does predict future ongoing decline and mortality. Repeated exacerbations result in accelerated lung function decline, is associated with some of the worst disruptive quality of life, and increase the cost through hospitalization and death. About 50% of patients remain at high risk despite current guideline-based therapy. Current approved biologics are limited to adults with inadequately controlled COPD and the hypereosinophilic phenotype. While that is often stated at 30%-40%, in my practice, it is not even that high. Next slide. This unmet need really begets the need for more upstream mediators that impact on more downstream mechanisms than currently available biologics.

Frank SciurbaProfessor of Pulmonary and Critical Care Medicine

IL-33 is a very interesting molecule that is released from epithelial cells following multiple stimuli, causing damage and death to those cells. It is released in its reduced form. That reduced form binds to the ST2 receptor on inflammatory cells and drive both directly and indirectly pathways of the recently hyped type 2 inflammation, but also the type 1 and type 17, which is the more common inflammatory pathways in COPD, which elicit neutrophils, a different inflammatory cell than eosinophils. That IL-33 can also be reduced or oxidized into the second form, and that second form binds to receptors EGFR and RAGE on epithelial cells, which drive mucus hypersecretion, another big problem in these patients, and epithelial remodeling, which results in more airway resistance and decline in lung function.

Frank SciurbaProfessor of Pulmonary and Critical Care Medicine

Both of these pathways really appear to be increasingly recognized and important in the downstream effects of IL-33. Next. Tozoracimab is a high-affinity monoclonal directed at IL-33, and first, its binding prevents then attachment to the ST2 receptor and impairs its downstream effects on the broad range of inflammation. It also prevents conversion of that reduced IL-33 to the oxidized form, and thus does not create the moieties that can bind to the EGFR and stimulate the mucus cell or the epithelial cell remodeling and mucus hypersecretion. The aim of this clinical trial that is the buzz today is to evaluate efficacy and safety of tozoracimab compared to placebo when added to standard of care, the care that is the maximum in actually most clinics in treating COPD and in those patients with a history of exacerbations. Next slide. The design of this study was a very inclusive study, more inclusive than most of the other biologics in many ways.

Frank SciurbaProfessor of Pulmonary and Critical Care Medicine

It included patients on optimized guideline-based therapy who continued to have exacerbations. It included current and former smokers, with the current smokers capped at 25%. The reason for that design was that a competitor found that there was some success in one of their phase II trials only in former smokers. That de-risked the product, but the company did not want to lose the possibility of a discovery in current smokers, and you will see those data. Post-bronchodilator FEV1s of less than 30% implies the worst stage of COPD, and recruitment went down to 20% predicted, so there were inclusion of GOLD 4 patients, which was not included in some of the competitors.

Frank SciurbaProfessor of Pulmonary and Critical Care Medicine

These patients were very symptomatic, and very importantly, eosinophils were not used in deciding who entered the clinical trial. The study design initially included two active arms of tozoracimab 300 milligrams subcutaneously every 4 weeks and every 8 weeks versus placebo. The Q8 week was halted because of additional information before unblinding that suggested the pharmacodynamics may not be adequate. The analysis will be just based on the Q4 week versus placebo. The primary endpoint in this experiment, related to what I had told you about former and current smokers, was a subset of the overall recruited population and the effects in just former smokers as the primary endpoint of annualized rate of moderate to severe exacerbations.

Frank SciurbaProfessor of Pulmonary and Critical Care Medicine

The first secondary endpoint in a hierarchy was then annualized rate of moderate to severe exacerbations in the overall population of current and former smokers. The company felt confident that they would get it but did not want to put it as the primary, but they got it as the first secondary. We will show you some of the results of the other hierarchical secondaries down the line. Next slide, please. The overall population was well balanced between placebo and active arm. Interestingly, the blood eosinophil count included approximately 40% of people in that most unmet need group of less than 150 eosinophils, which is not covered by any of the other biologics. Overall there was a very severe population of that less than 30% predicted that represented about 20% of the patients. Next slide. These are the big results, the primary results.

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