[{"id":"boreas-exacerbations","name":"Annualized moderate-to-severe COPD exacerbation rate","type":"PRIMARY","unit":"events/year","results":[{"notes":"30% reduction vs placebo","value":0.78,"arm_id":"dupixent-boreas","arm_name":"Dupilumab 300mg"},{"notes":"Rate ratio 0.70 (95% CI 0.58-0.86), p=0.0005","value":1.1,"arm_id":"placebo-boreas","arm_name":"Placebo"}],"timepoint":"Week 52","description":"Annualized rate of moderate or severe COPD exacerbations. Moderate = requiring systemic corticosteroids and/or antibiotics. Severe = requiring hospitalization or ER visit. Patients had blood eosinophils ≥300 cells/μL."}]
BOREAS met primary endpoint: 30% reduction in moderate-to-severe COPD exacerbations (RR 0.70, 95% CI 0.58-0.86, p=0.0005). Pre-BD FEV1: +160 mL vs placebo at Week 12 (p<0.001). First biologic to show exacerbation AND FEV1 benefit in COPD.
BOREAS (n=939, 52 weeks): Well-tolerated in COPD. No new safety signals vs asthma/AD experience. Most common: viral infection 14% vs 12%, headache 8% vs 7%.
BOREAS was practice-changing — first biologic ever approved for COPD. The 30% exacerbation reduction + 160mL FEV1 improvement is impressive because IL-5 biologics FAILED in COPD. IL-4Rα blockade works because it addresses broader type 2 inflammation beyond just eosinophils. NOTUS confirmed the result. This opened a massive new market for Dupixent.