{
  "abstract": "Background: Neutrophilic inflammation is a common feature of COPD. Mitiperstat, an inhibitor of myeloperoxidase expressed in neutrophils, may have potential as a COPD treatment.\n\nMethods: This phase 2a, randomised, placebo-controlled, double-blind, parallel-arm, event-driven trial evaluated the efficacy and safety of mitiperstat 5 mg once daily for up to 24 weeks (CRESCENDO; ClinicalTrials.gov: NCT05492877). Adults (40–80 years) with moderate-to-severe COPD, at high risk of exacerbation and receiving dual or triple inhaled therapy were included. The primary end-point was time to first composite end-point for exacerbations in COPD (COPDCompEx) event. Secondary end-points included time to first moderate-to-severe COPD exacerbation, post-bronchodilator forced expiratory volume in 1 s (post-BD FEV1) change at week 12, respiratory symptoms, disease impact and safety.\n\nResults: Overall, 381 participants (mean age 66.0 years; 39.6% female) were randomised to mitiperstat (n=189) or placebo (n=192). In total, 125 (66.1%) mitiperstat-treated versus 125 (65.1%) placebo-treated participants experienced COPDCompEx events over 24 weeks. There was no improvement in time to first COPDCompEx event (hazard ratio (HR) 1.07, 90% CI 0.87–1.32; p=0.599) or time to first moderate-to-severe COPD exacerbation (HR 1.23, 90% CI 0.88–1.73) with mitiperstat versus placebo. Improvements in post-BD FEV1, respiratory symptoms or disease impact were not seen with mitiperstat. A similar proportion of participants in both groups reported adverse events; seven mitiperstat-treated participants and two placebo-treated participants had pneumonia during the study.\n\nConclusion: These results indicate that the risks outweigh the benefits of mitiperstat as a treatment for COPD.",
  "abstract_shown": true,
  "affiliations": [
    "National Institute for Health Research Patient Recruitment Centre and Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK",
    "Clinical Development, Respiratory and Immunology, AstraZeneca, Cambridge, UK",
    "General Practitioners Research Institute, Groningen, The Netherlands",
    "Observational and Pragmatic Research Institute, Singapore, Singapore",
    "Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands",
    "Department of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands",
    "Research and Early Development, Respiratory and Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden",
    "Translational Science and Experimental Medicine, Respiratory and Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden",
    "R&I Biometrics and Statistical Innovation, Late Respiratory and Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK",
    "Respiratory Pharmacology Group, National Heart and Lung Institute, Imperial College London, London, UK",
    "Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Gothenburg, Sweden",
    "Translational Science and Experimental Medicine, Research and Early Development, Respiratory and Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK",
    "Early Biometrics, Late-Stage Development Respiratory and Immunology, BioPharmaceuticals R&D, AstraZeneca, Barcelona, Spain",
    "Division of Respiratory Medicine and Gastroenterology, University of Dundee, Dundee, UK",
    "King's Centre for Lung Health, Peter Gorer Department of Immunobiology, King's College London, London, UK",
    "UCL Respiratory, University College London, London, UK",
    "Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital – Research Institute, Medical University of Lodz, Łódź, Poland"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 17,
  "authors": [
    {
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        0
      ],
      "name": "Dinesh Saralaya"
    },
    {
      "affs": [
        1
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      "name": "M. Nubli Mustapa"
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    {
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        1
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      "name": "João Ferreira"
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    {
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        2,
        3,
        4,
        5
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      "name": "Janwillem W.H. Kocks",
      "orcid": "0000-0002-2760-0693"
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        6
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      "name": "Wayne Brailsford"
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    {
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        7
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      "name": "Sanna Rosengren"
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    {
      "affs": [
        8
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      "name": "Enti Spata"
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    {
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        6,
        9
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      "name": "Maria G. Belvisi",
      "orcid": "0000-0003-1652-4370"
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    {
      "affs": [
        10
      ],
      "name": "Jacob Leander",
      "orcid": "0000-0002-7411-2967"
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    {
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        10
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      "name": "Camille Riff"
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    {
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        11
      ],
      "name": "Giovanna De Palo"
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    {
      "affs": [
        12
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      "name": "Daniel Windgassen"
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    {
      "affs": [
        13
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      "name": "James D. Chalmers"
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    {
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      ],
      "name": "Richard E.K. Russell"
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    {
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        15
      ],
      "name": "John R. Hurst",
      "orcid": "0000-0002-7246-6040"
    },
    {
      "affs": [
        16
      ],
      "name": "Adam Śmiałowski"
    },
    {
      "affs": [
        1
      ],
      "name": "Rod Hughes",
      "orcid": "0009-0006-1200-5580"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/790gy5xackrjm.bib",
  "cited_by": 1,
  "doi": "10.1183/13993003.02567-2025",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13735183/",
  "id": "790gy5xackrjm",
  "issns": [
    "0903-1936",
    "1399-3003"
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  "landing_url": "https://doi.org/10.1183/13993003.02567-2025",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
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  "native_subjects": [
    [
      "heading",
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    ],
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      "heading",
      "COPD"
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      "heading",
      "Original Research Article"
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      "2740|Chronic Obstructive Pulmonary Disease (COPD) Research"
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  "pdf_url": null,
  "pmcid": "PMC13735183",
  "pmid": "42562590",
  "published": "2026-11-05",
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  "ris": "https://research.draconitic.com/paper/790gy5xackrjm.ris",
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      "field": "medicine",
      "origin": "openalex:2740|Chronic Obstructive Pulmonary Disease (COPD) Research",
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  ],
  "title": "A phase 2a, double-blind, randomised, placebo-controlled trial of the myeloperoxidase inhibitor, mitiperstat, in participants with COPD",
  "title_text": "A phase 2a, double-blind, randomised, placebo-controlled trial of the myeloperoxidase inhibitor, mitiperstat, in participants with COPD",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:20:54Z",
  "url": "https://research.draconitic.com/paper/790gy5xackrjm",
  "venue": "The European Respiratory Journal",
  "versions": []
}