<a href="${link:{uuid:{d4dafd48-4837-4ef7-ab1b-76db53f754ab},repository:{dam},path:{/Portal/UK/Prescribing-links/Dupixent%20(COPD)%20PI%20GB%20September%202024.pdf}}}" target="_blank">Dupixent (dupilumab) Prescribing Information (GB only)</a>

<h2>Type 2 Inflammation may increase the risk of exacerbations and lung function impairment in COPD6,7</h2>
<h3>COPD is characterised by mucus production, airway obstruction, and coughing8</h3>

<h3>Inflammation manifests systemically and locally</h3>

<ul>
 <li>Chronic inflammation causes structural changes, including narrowing of the airways and decreased lung elasticity8</li>
 <li>Studies have identified a relationship between inflammation and mucus hypersecretion in respiratory conditions such as COPD9</li>
</ul>
&nbsp;&nbsp;

<h2>Look for elevated blood eosinophils&nbsp;- A Biomarker of Type 2 Inflammation in COPD8</h2>

<h4>&nbsp;</h4>
<h3>Elevated eosinophils in COPD are a treatable trait and marker of type 2 inflammation11</h3>
The 2024 GOLD Report recognises elevated blood EOS as a clinically used biomarker in identifying COPD with type 2 inflammation8
<h2>Type 2 inflammation in COPD can involve multiple pathways, cytokines, and inflammatory cells12</h2>

<h2>IL-4, IL-13, and IL-5 are type 2 cytokines involved in COPD</h2>

&nbsp;&nbsp;aBased on findings from 5 studies in COPD patients without asthma. Eosinophil levels used to define type 2 inflammation ranged from ≥300 cells/μL to ≥340 cells/μL (blood), ≥2% in induced sputum or 3% in peripheral blood. Percentages of patients with type 2 inflammation ranged from 12.3% to ~40%6,7 bA severe exacerbation was defined as a hospitalisation due to COPD. Exacerbations had to be a minimum of 4 weeks apart to be considered separate exacerbations.10 cIn a cohort of patients with EOS &gt;200 cells/μL.9 dReproduced with permission of the American Thoracic Society. Fritzsching B et al. Am J Respir Crit Care Med. 2015;191(8):902-9139 eAlcian blue PAS staining of mucus in airway epithelial cells.9 fResults from an observational study of 1553 patients with GOLD spirometry grade 2-4 COPD (postbronchodilator FEV1/FVC ratio &lt;0.7, with FEV, &gt;80% predicted)6 gResults from a 1-year observational study of 479 patients with COPD, 173 of whom had blood eosinophil levels ≥200 cells/μL and/or ≥2% of the total white blood cell count.7 
 COPD, chronic obstructive pulmonary disease; EOS, eosinophils; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; GOLD, Global Initiative for Chronic Obstructive Lung Disease; IFN-y, interferon-gamma; ILC2, innate lymphoid type-2 cells; MUC5AC, mucin 5AC; PAS, periodic acid-Schiff; TNF-a, tumor necrosis factor alpha; TSLP, thymic stromal lymphopoietin.

Dupixent (dupilumab) Prescribing Information (GB ONLY)

CHRONIC-OBSTRUCTIVE-PULMONARY-DISEASE-(COPD)

Role of type 2 inflammation 

<h2>The SGRQ measures the qualitative impact of COPD1,2</h2>
Some domains evaluated by the SGRQ include1,2:

Cough

Sputum production

Breathlessness

Wheezing

Exacerbations

Work activities

Daily activities*

Medication use

*Such as walking upstairs or getting dressed.
<h2>E-RS:COPD assesses COPD symptoms3,4,b</h2>
Some domains evaluated by the E-RS:COPD include3,4:

Breathlessness

Cough &amp; Sputum&nbsp;

Chest symptoms

Additional Attributes (tired or weak, sleep disturbance, scared or worried)

<h4>This is not an exhaustive list of items evaluated by the SGRQ and E-RS:COPD.</h4>

a The SGRQ is a 50-item questionnaire designed to measure the qualitative impact of COPD on overall health , daily life, and perceived well-being. Higher scores mean greater disease severity.1,2 b E-RS:COPD is an 11-item patient-reported derivative tool that measures the effect of treatment on respiratory symptom severity in patients with stable COPD . Higher scores mean greater disease severity. 3,4
 
 COPD, chronic obstructive pulmonary disease; E-RS:COPD, Evaluating Respiratory Symptoms in COPD; QoL, quality of life; SGRQ, St George’s Respiratory Questionnaire

RESPIRATORY

Quality of life and symptom measurement in COPD patients

<h2>COPD exacerbation risk has been shown to accelerate after each exacerbation.2,a&nbsp;</h2>
<h3>Exacerbation risk accelerates after each exacerbation2</h3>

*Severe exacerbations were defined as those which resulted in hospitalisation with a primary discharge diagnosis of COPD2
<h3>Despite triple inhaled therapyc, many patients remain symptomatic as defined by persistent symptoms and exacerbations.2</h3>

<h2>COPD exacerbations may lead to an accelerated rate of decline in lung function3,d</h2>

<ul>
 <li>
 Rate of FEV1 decline nearly double3</li>
 <li>
 Lung function decline may occur after only one COPD exacerbation3</li>
</ul>

aBased on data from a large population-based cohort of 73,106 Canadian patients (mean age 75 years) who were hospitalised for the first time because of a severe exacerbation of COPD (1990-2005, followed until death or March 31, 2007). The hazard functions of successive hospitalised COPD exacerbations and all-cause mortality over time were estimated, and HRs adjusted for age, sex, calendar time and comorbidity.&nbsp;2 bAdjusted for age, sex, calendar time, and the modified Chronic Disease Score.2 cOr double inhaled therapy if ICS is contraindicated.4 dFEV1 decline after a single moderate-to-severe exacerbation. Based on a retrospective analysis of data from 586 patients with moderate-to-severe COPD.3&nbsp; 
 aHR, adjusted hazard ratio; COPD, chronic obstructive pulmonary disease; FEV1, forced expiratory volume in 1 second; QoL, quality of life&nbsp;

The impact of exacerbations in COPD

<a href="${link:{uuid:{41d82ab0-c017-4e79-be57-e5930764c364},repository:{dam},path:{/Portal/UK/Prescribing-links/Rezurock%20PI%20GB.pdf}}}" target="_blank">Prescribing Information Rezurock belumosudil (tablets)</a>

<h2>Patient impact and treatment goals of cGvHD</h2>
Patients with cGvHD experience a range of physical, functional, psychosocial, and economic 
 deficits.1-3&nbsp;Preventing disease progression and irreversible damage are critical goals in the management of cGvHD.&nbsp;

The inflammation and fibrosis associated with cGvHD can lead to multiple physical ailments impacting numerous organs.4-6

Psychological distress is associated with worsening QoL, physical function and cGvHD symptom burden.7

Only 37.5% of patients with cGvHD are able to return to work.8-9&nbsp;This is associated with decreased QoL, activity level and physical and mental functioning.

Download a summary of the affect that cGvHD has on patients and explore how their quality of life can be impacted. (For full interactivity, download&nbsp;and view in Adobe Acrobat).

TRANSPLANT

Dawn Hart, Katharina Ecsy, Luke Skinner, Arunesh Sil, Richard Hudson and Matthew Bradberry

This poster presents a qualitative study on how cGvHD affects the QoL for patients and their caregivers. It highlights the major challenges faced, especially after multiple failed treatments. The study, based on interviews with patients and caregivers, examines the physical, emotional, social and financial burdens of cGvHD. Key findings include the disease's impact on daily life, the added strain from treatment side effects, and the psychological and financial toll.

Dawn Hart, Katharina Ecsy, Luke Skinner, Arunesh Sil, Richard Hudson and Matthew Bradberry
This poster showcases a quantitative study on how cGvHD affects the QoL for patients and their caregivers. It reveals the severe physical symptoms, heavy treatment burden, and emotional challenges for patients, along with the significant anxiety and financial strain for caregivers. The study highlights the urgent need for better support and management strategies to improve quality of life for both patients and caregivers.

Abbreviations

References

REZUROCK®▼ (belumosudil) Prescribing Information (GB ONLY)

cGvHD Quality of Life

<h2>Early onset and complexity of fibrosis in cGvHD</h2>
Fibrosis in cGvHD may happen earlier than expected.
<ul>
 <li>Inflammation and fibrosis can both occur within the first year post allogenic&nbsp;hematopoietic stem&nbsp;cell transplantation (alloHSCT), but sometimes develop many years after.1-2</li>
 <li>The exact relationship between inflammation and fibrosis is complex and not yet fully understood.3</li>
 <li>Fibrosis may be viewed as a natural consequence of inflammation, but in fact,&nbsp;research suggests it may begin developing prior to&nbsp;any symptoms of cGvHD.4-6</li>
</ul>

<h2>The need for early intervention</h2>
Despite the heterogeneity of cGvHD presentation, the defining features are inflammation and fibrosis1,3&nbsp;which can affect multiple organs.&nbsp;
The condition can affect the skin, liver, lungs, eyes and gastrointestinal system, among others.
Acting as early as possible to target both the fibrotic and inflammatory components of cGvHD could be crucial in appropriate patients.7,9

Gain a deeper understanding of the mechanisms behind cGvHD, including its key drivers - inflammation and fibrosis. (For full interactivity, download&nbsp;and view in Adobe Acrobat).

Understanding the mechanism of cGvHD: Inflammation and Fibrosis

<h3>This is intended for HCPs practising in Great Britain (England, Scotland, Wales) only.</h3>
<a href="${link:{uuid:{41d82ab0-c017-4e79-be57-e5930764c364},repository:{dam},path:{/Portal/UK/Prescribing-links/Rezurock-PI-GB-March-2023.pdf}}}" target="_blank">Prescribing Information (GB only)</a>

<h2>ROCKstar study&nbsp;</h2>
<h3>Responses&nbsp;with REZUROCK were seen after failure of ≥2 prior lines of therapy1</h3>
Study design1:&nbsp;ROCKstar was a pivotal phase 2, open label, non-controlled, randomized, multicenter study that evaluated the efficacy and safety of REZUROCK in patients with cGvHD after receiving 2 to 5 prior lines of systemic therapy.&nbsp;
Treatment consisted of REZUROCK 200 mg and was administered continuously until clinically significant progression of cGvHD or unacceptable toxicity.&nbsp;
Primary end point1:&nbsp;Best ORR at any time, defined as the proportion of subjects who achieved CR or PR according to the 2014 NIH cGVHD Consensus Criteria.

Clinically meaningful&nbsp;and&nbsp;statistically significant&nbsp;best ORR&nbsp;of 74%&nbsp;(n=66, 95% CI, 62-84)2&nbsp;at 1 year was maintained after 3 years of treatment with REZUROCK (n=77, 95% CI, 63-83)3.

Responses across&nbsp;all evaluated organs, including those with fibrotic manifestations1,4.

Median time to response to the initiation of new systemic cGVHD therapy was 100.3 weeks (54.14-NA)2.

Over 3 years, 65% (n/N=50/76) reduced their CS dose and 27% (n/N=21/73) discontinued CS therapy3

ORR, overall response rate; CR, complete response;&nbsp;CS, corticosteroids;&nbsp;PR, partial response; FFS, failure free survival; OS, overall survival.

<a href="/uk/transplant">SEE MORE FROM SCIENCE</a>

<h3>REZUROCK</h3>
Get the latest updates&nbsp;about&nbsp;REZUROCK​. 
 This is intended for&nbsp;HCPs&nbsp;practising&nbsp;in&nbsp;Great Britain (England,&nbsp;Scotland, Wales) only​.

<h3>Safety Profile</h3>
Download safety profile summary.&nbsp; 
 This is intended for HCPs practising Great Britain (England, Scotland, Wales) only​.

Get in touch with the Transplant Team

Study Summary

<table border="0" cellpadding="1" cellspacing="1" style="width: 500px;">
 <tbody>
 <tr>
 <td style="background-color: rgb(212, 22, 117);">
 <h3>In the 3-year follow-up to the 2021 ROCKstar study, no new safety signals were observed.1</h3></td>
 </tr>
 </tbody>
</table>

<h2>In the ROCKstar and KD025-208 studies 
 REZUROCK was generally well tolerated in patients with cGVHD2</h2>
<h3>Safety was evaluated across 2 clinical studies (n=186)3,4</h3>
Consider the safety profile of REZUROCK in patients with cGVHD who often receive immunosuppressive therapy.&nbsp;
Please refer to the full Summary of Product Characteristics before prescribing.

The most common adverse reactions leading to discontinuation were nausea (2.4%) and headache (2.4%). Adverse reactions leading to dose interruption occurred in 9.6% of patients and were mainly investigations (3.6%), including ALT increased, GGT increased and blood creatine phosphokinase increased (1.2% each), and infections (2.4%)2

The most common adverse reactions (≥5%) were asthenia (21.0%), nausea (12.4%), liver function test abnormalities of elevation of AST (7.5%), elevation of ALT (7.0%) and elevation of GGT (4.8%), headache (8.6%), diarrhoea (7.0%) and musculoskeletal pain (5.9%)2

Serious adverse reactions were pneumonia (1.1%), cellulitis, infectious colitis, staphylococcal bacteraemia, diarrhoea, nausea, vomiting, microangiopathic haemolytic anaemia, multiple organ dysfunction syndrome and cGVHD (0.5% each)2

There were&nbsp;no reports of CMV&nbsp;infection in both the ROCKstar and the foundational, dose-finding KD025-208 studies, and only&nbsp;1 report of CMV reactivation&nbsp;in total3,4

In the ROCKstar and KD025-208 clinical studies of REZUROCK,&nbsp;grade ≥3 cytopenias&nbsp;were reported in&nbsp;&lt;4%&nbsp;and&nbsp;4%&nbsp;of patients, respectively3,4

<h3>REZUROCK</h3>
Get the latest updates&nbsp;about&nbsp;REZUROCK​. 
 This is intended for&nbsp;HCPs&nbsp;practising&nbsp;in&nbsp;Great Britain (England,&nbsp;Scotland, Wales) only​

<h3>ROCKstar Study</h3>
Download ROCKstar study summary. 
 This is intended for HCPs&nbsp;practising&nbsp;in&nbsp;Great Britain (England, Scotland,&nbsp;Wales) only​

Safety Profile

This is intended for HCPs practising in Great Britain (England, Scotland, Wales) only.
<a href="${link:{uuid:{edff588a-de09-4893-a850-fff622441572},repository:{dam},path:{/Portal/UK/Prescribing-links/Admelog.pdf}}}" target="_blank">Prescribing Information (GB only)</a>

<h2>Head-to-head studies Admelog® vs Humalog®</h2>

<h3>Similar PK/PD profile1</h3>
PK/PD profiles in the biosimilar, Admelog, were similar to the EU-approved Humalog in adult males with Type 1 diabetes1

TYPE-2-DIABETES

TYPE-1-DIABETES

DIABETES

<h3>Similar mean HbA1C reduction2,3</h3>
Similar mean HbA1C reduction from baseline to Week 26 in Admelog and Humalog groups, in both Type 1 and Type 2 diabetes2,3

<h3>Similar long-term safety and tolerability profiles2,3</h3>
Similar rates of patients with at least one hypoglycaemic event, regardless of the category, was observed in both Admelog and Humalog groups in Type 1 and Type 2 diabetes2,3

<a href="/uk/type-2-diabetes">SEE MORE FROM SCIENCE</a>

<h3>Admelog</h3>
Admelog is indicated for the treatment of adults and children with diabetes mellitus who require insulin for the maintenance of normal glucose homeostasis and for the initial stabilisation of diabetes mellitus.&nbsp;
This is intended for HCPs practising in Great Britain (England, Scotland, Wales) only.

<h3>Patient Website</h3>
Find resources and support for your patients on Admelog®. Help patients understand the basics of living and staying well with diabetes and how to have a positive start and experience with the medication prescribed to them.

<h2>Get in touch with the Diabetes Team</h2>

Admelog® (insulin lispro 100 units/mL)
   

Admelog® (insulin lispro 100 units/mL) Prescribing Information (GB only)

Head to Head Studies

This is intended for HCPs practising in Great Britain (England, Scotland, Wales) only.

<a href="${link:{uuid:{62efcdcd-db16-49b4-8041-55c212a401fa},repository:{dam},path:{/Portal/UK/Prescribing-links/Trurapi-PI-GB-April-2023.pdf}}}" target="_blank">Prescribing Information (GB only)</a>

<h2>Head-to-head studies Trurapi®&nbsp;vs NovoRapid®</h2>

<h3>Similar PK/PD profile in adults with T1DM1</h3>
PK/PD profiles in the biosimilar Trurapi®, were similar to the UK and EU-approved NovoRapid®&nbsp;and US-approved Novolog®&nbsp;in patients with T1DM.1&nbsp;

<h3>Similar mean HbA1C&nbsp;reduction in adults with T1DM and T2DM2</h3>
At week 26, HbA1C&nbsp;was -0.38% for Trurapi®&nbsp;group vs -0.30% for NovoRapid®/NovoLog®&nbsp;group. Similar mean HbA1C reduction from baseline to Week 26 in Trurapi®&nbsp;and NovoRapid®/Novolog®&nbsp;groups were observed in patients with either T1DM or T2DM.2

<h3>Similar long-term safety and tolerability profiles in adults with T1DM and T2DM2,3</h3>
Similar incidence rates of any hypoglycaemic events (≥1 event) in both the T1DM and overall population were observed in both Trurapi®&nbsp;and NovoRapid®/Novolog®&nbsp;groups.2,3
For more information and for data from the 6-month safety extension trial, download the clinical summary.&nbsp;

<h2>Want to know more about the bioequivalence data?</h2>

Watch this short video summarising the similar PK/PD profile (T1DM), efficacy, safety and tolerability profile (T1DM and T2DM) in Trurapi® vs. NovoRapid® from two clinical studies in adults.1,2

<a href="/uk/type-1-diabetes">SEE MORE FROM SCIENCE</a>

<h3>Trurapi</h3>
Trurapi is indicated for the treatment of diabetes mellitus in adults, adolescents and children aged 1 year and above.&nbsp;
This is intended for HCPs practising in Great Britain (England, Scotland, Wales) only.

<h3>Patient Website</h3>
Find resources and support for your patients on&nbsp;Trurapi®. Help patients understand the basics of living and staying well with diabetes and how&nbsp;to have a positive start and experience with the&nbsp; medication prescribed to them.

Trurapi®▼ (insulin aspart 100 units/mL)  

Trurapi®▼ (insulin aspart 100 units/mL) Prescribing Information (GB only)

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Latest Articles

Role of type 2 inflammation

Quality of life and symptom measurement in COPD patients

The impact of exacerbations in COPD

cGvHD Quality of Life

Understanding the mechanism of cGvHD: Inflammation and Fibrosis

Study Summary

Safety Profile

Head to Head Studies

Head to Head Studies