COPD triple therapy Breztri enters major hospital formularies

Reimbursed from September...Demonstrates reduced exacerbation risk versus LAMA/LABA

Clears Drug Committee reviews at major hospitals including Seoul National University Hospital and Severance Hospital

The COPD triple inhaler ‘Breztri’ is gaining access to formularies at major hospitals in Korea.

According to industry sources on the 27th, AstraZeneca Korea’s Breztri Aerosphere (budesonide/glycopyrronium/formoterol), a maintenance treatment for moderate to severe chronic obstructive pulmonary disease (COPD), has won approval from the drug committees (DCs) of major tertiary hospitals in Korea, including Seoul National University Hospital and Severance Hospital.

The drug has been gradually expanding its reach since gaining national health insurance coverage in September.

Breztri is a single-inhaler triple therapy combining an inhaled corticosteroid (ICS), a long-acting beta2-agonist (LABA), and a long-acting muscarinic antagonist (LAMA). It is used twice daily as maintenance treatment to control symptoms and reduce exacerbations in adults with COPD.

The drug’s clinical efficacy and safety profile have been demonstrated in global Phase III trials including ETHOS and KRONOS.

ETHOS (The Efficacy and Safety of Triple Therapy in Obstructive Lung Disease) was a 52-week, multicenter, randomized, double-blind Phase III trial involving 8,588 patients aged 40 to 80 years with moderate to very severe COPD.

In the study, Breztri Aerosphere significantly reduced the annual rate of moderate or severe COPD exacerbations by approximately 24% relative to LAMA/LABA dual therapy and by approximately 13% relative to ICS/LABA.

Also, a post hoc analysis of ETHOS found a significant reduction in all-cause mortality with Breztri Aerosphere versus LAMA/LABA.

Another pivotal trial, KRONOS, demonstrated improvements in lung function with Breztri Aerosphere.

KRONOS was a 24-week global Phase III trial involving 1,902 patients with moderate to very severe COPD. At Week 24, Breztri Aerosphere produced a 22 mL improvement in lung function versus LAMA/LABA and a 74 mL improvement versus ICS/LABA (BFF MDI).

Meanwhile, COPD is a major chronic pulmonary disease caused by abnormalities in the airways and alveoli, such as bronchitis, bronchiolitis, and emphysema. It is characterized by chronic respiratory symptoms such as dyspnea and cough, and is a heterogeneous disease characterized by persistent and progressive airflow limitation.

The 2026 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines recommend triple combination therapy of ICS, LAMA, and LABA for patients receiving ICS+LABA who either have no current exacerbations but continue to have a high symptom burden, or have exacerbations with a blood eosinophil count of 100 cells/µL or higher.