EXACERBATIONS

Despite inhaled triple therapy, patients with COPD remain at high risk of exacerbations1,2

In an observational analysis of patients taking optimized inhaled triple therapy*3:

64% OF PATIENTS

EXPERIENCED ≥1 MODERATE EXACERBATION REQUIRING OCS AND/OR ANTIBIOTICS

32% OF PATIENTS

HAD ≥1 SEVERE EXACERBATION REQUIRING HOSPITALIZATION

Woman With Exacerbation and Statistics Highlighting COPD Exacerbation Rates and Hospitalization Risk Woman With Exacerbation and Statistics Highlighting COPD Exacerbation Rates and Hospitalization Risk

Even 1 exacerbation can lead to more serious events, including death

Icon Indicating That A COPD Exacerbation Can Accelerate Lung Function Decline And Increase Future Risk And Mortality. Icon Indicating That A COPD Exacerbation Can Accelerate Lung Function Decline And Increase Future Risk And Mortality.
A single moderate exacerbation

can increase the risk of future exacerbations BY 70%4-7

Icon Representing Mortality Risk After Severe COPD Exacerbations Icon Representing Mortality Risk After Severe COPD Exacerbations
Nearly 1 in 5 patients

WILL DIE WITHIN 12 MONTHS AFTER A SEVERE EXACERBATION8,9

IL-33 is associated with a twofold increased risk of COPD exacerbations over 1 year10-13

IL-33 may leave patients at risk for future COPD exacerbations

Future exacerbations can contribute to repeated OCS and antibiotic use, impacting both patients’ lives and healthcare systems3,11,12,14-16

Over a 1-year baseline period*3,17:

Icon Representing Oral Corticosteroid(OCS) Prescriptions Associated With COPD Exacerbations Icon Representing Oral Corticosteroid(OCS) Prescriptions Associated With COPD Exacerbations

90% of Patients received ≥1 OCS prescription

with an average exposure of 73 days

Icon Representing Antibiotic Prescriptions Related To COPD Exacerbations. Icon Representing Antibiotic Prescriptions Related To COPD Exacerbations.

~90% of Patients HAD ≥1 prescription for antibiotics

corresponding to a mean annual exposure of 45 days

In patients with COPD TAKING triple therapy,

IL-33 activity can persist, contributing to exacerbations and subsequent OCS and antibiotic use3,10-12,18,19

COULD IL-33 REVEAL NEW WAYS OF THINKING ABOUT COPD?

Learn more about the dual pathways of IL-33 and their roles in COPD.

Sign up to stay informed

Share page via email Icon

Connect with an MSL

Open link in a new window

COPD=chronic obstructive pulmonary disease; IL=interleukin; MSL=medical science liaison; OCS=oral corticosteroid.

* Data from follow-up period (mean duration 21.2 months) of SIRIUS, a US retrospective cohort study of patients with COPD (N=4920) with 1 year of continuous triple therapy and a history of frequent exacerbations, defined as ≥2 moderate or ≥1 severe exacerbation per year during 12-month baseline period. Study used Optum integrated claims and electronic health record database (study period: 2015-2019).3

  1. Rabe KF, Rennard S, Martinez FJ, et al. Targeting type 2 inflammation and epithelial alarmins in chronic obstructive pulmonary disease: a biologics outlook. Am J Respir Crit Care Med. 2023;208(4):395-405. doi:10.1164/rccm.202303-0455CI
  2. Celli BR, Anzueto A, Singh D, et al. The emerging role of alarmin-targeting biologics in the treatment of patients with COPD. Chest. 2025;167(5):1346-1355. doi:10.1016/j.chest.2024.09.049
  3. Nordon C, Carstens D, Fagerås M, et al. Characteristics and outcomes of people with COPD who experience exacerbations while on inhaled triple therapy: results of the SIRIUS I cohort study in the US (2015-2019). Int J Chron Obstruct Pulmon Dis. 2025;20:1851-1864. doi:10.2147/COPD.S513573
  4. Hurst JR, Skolnik N, Hansen GJ, et al. Understanding the impact of chronic obstructive pulmonary disease exacerbations on patient health and quality of life. Eur J Intern Med. 2020;73:1-6. doi:10.1016/j.ejim.2019.12.014
  5. Waeijen-Smit K, Peerlings DEM, Jörres RA, et al. GOLD COPD exacerbation history categories and disease outcomes. JAMA Netw Open. 2024;7(12):e2445488. doi:10.1001/jamanetworkopen.2024.45488
  6. Whittaker H, Rubino A, Müllerová H, et al. Frequency and severity of exacerbations of COPD associated with future risk of exacerbations and mortality: a UK routine health care data study. Int J Chron Obstruct Pulmon Dis. 2022;17:427-437. doi:10.2147/COPD.S346591
  7. Whittaker H, Rubino A, Müllerová H, et al. Frequency and severity of exacerbations of COPD associated with future risk of exacerbations and mortality: a UK routine health care data study. Int J Chron Obstruct Pulmon Dis. 2022;17(suppl):427-437. doi:10.2147/COPD.S346591
  8. Vogelmeier CF, Friedrich FW, Timpel P, et al. Impact of COPD on mortality: an 8-year observational retrospective healthcare claims database cohort study. Respir Med. 2024;222:107506. doi:10.1016/j.rmed.2023.107506
  9. Ho TW, Tsai YJ, Ruan SY, Huang CT, Lai F, Yu CJ; HINT Study Group. In-hospital and one-year mortality and their predictors in patients hospitalized for first-ever chronic obstructive pulmonary disease exacerbations: a nationwide population-based study. PLoS One. 2014;9(12):e114866. doi: 10.1371/journal.pone.0114866
  10. Joo H, Park SJ, Min KH, Rhee CK. Association between plasma interleukin-33 level and acute exacerbation of chronic obstructive pulmonary disease. BMC Pulm Med. 2021;21(1):86. doi:10.1186/s12890-021-01423-8
  11. Kim SW, Rhee CK, Kim KU, et al. Factors associated with plasma IL-33 levels in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2017;12:395-402. doi:10.2147/COPD.S120445
  12. Riera-Martínez L, Cànaves-Gómez L, Iglesias A, Martin-Medina A, Cosío BG. The role of IL-33/ST2 in COPD and its future as an antibody therapy. Int J Mol Sci. 2023;24(10):8702. doi:10.3390/ijms24108702
  13. Kearley J, Silver JS, Sanden C, et al. Cigarette smoke silences innate lymphoid cell function and facilitates an exacerbated type I interleukin-33-dependent response to infection. Immunity. 2015;42(3):566-579. doi:10.1016/j.immuni.2015.02.011
  14. Tse G, Emmanuel B, Ariti C, et al. A long-term study of adverse outcomes associated with oral corticosteroid use in COPD. Int J Chron Obstruct Pulmon Dis. 2023;18:2565-2580. doi:10.2147/COPD.S433326
  15. Vollenweider DJ, Frei A, Steurer-Stey CA, Garcia-Aymerich J, Puhan MA. Antibiotics for exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2018;10(10):CD010257. doi:10.1002/14651858.CD010257.pub2
  16. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for Prevention, Diagnosis and Management of COPD: 2026 Report. Accessed July 6, 2026. https://goldcopd.org/2026-gold-report-and-pocket-guide/
  17. Nordon C, Carstens D, Fagerås M, et al. Exacerbation and mortality in COPD patients on triple inhaler and at high exacerbation risk. Poster presented at: European Respiratory Society (ERS) Congress 2024; September 7-11, 2024; Vienna, Austria. Poster PA1287.
  18. Lea S, Higham A, Beech A, Singh D. How inhaled corticosteroids target inflammation in COPD. Eur Respir Rev. 2023;32(170):230084. doi:10.1183/16000617.0084-2023
  19. Abdo M, Pederson F, Kirsten A-M, et al. Association of airway inflammation and smoking status with IL-33 level in sputum of patients with asthma or COPD. Eur Respir J. 2024;64(3):2400347. doi:10.1183/13993003.00347-2024