Chronic respiratory conditions, including asthma, COPD and CRSwNP, can manifest through severe, chronic and progressive symptoms, taking a significant toll on a person’s ability to breathe comfortably and live life free from the burden of their disease. Until a few years ago, there were limited advanced therapies available to treat patients suffering from severe respiratory diseases.

“I once had a patient in her forties with severe asthma. Not many treatment options were available back then – she was taking steroids and had to come back and forth to the hospital. The medication had side effects and her symptoms would recur, so she waited longer and longer until her attacks would return. One time, she waited too long and sadly passed away,” shared a Sanofi researcher and former physician. “It is stories like hers that made me realize how critical scientific research in immunology is to help to advance diverse treatment options.”

When it comes to sheer physical ability, nothing hinders the body quite like the inability to breathe properly. Chronic respiratory diseases have a significant physical, psychological and economic impact on patients and caregivers, as well as an economic burden on the healthcare system.

At Sanofi, we have longstanding expertise in immunology research that has helped spark a paradigm shift in how we address specific chronic inflammatory diseases, including respiratory conditions. Through innovation, we, alongside our partner Regeneron, have significantly advanced care across chronic respiratory diseases with Type 2 inflammation, providing new solutions for the treatment of some of these diseases, including the emergence of biologic treatments.

But chronic respiratory conditions are complex and heterogenous. With the evolution of research in the field, it has become clear that there is a broad spectrum of inflammation underlying these conditions, and they are often driven by multiple pathways that can differ from person to person. Because of this, not all patients have the same response to treatment and may have different clinical presentations. This means the next frontier in immunology requires us to look beyond Type 2 inflammation.   

Through our research and robust pipeline, we are pursuing diverse solutions, exploring novel pathways and modalities and seeking to help broader patient populations, including those with less severe disease, hard-to-treat conditions or those who do not respond to current treatments. By advancing innovative science, we aim to raise efficacy ceilings, intervene earlier in the disease, modify disease progression, and tailor treatment to patient needs.

Ultimately, our goal is to redefine the treatment paradigm in chronic respiratory disease and move toward a future where we treat these conditions with a personalized approach, addressing the specific underlying disease mechanisms driving each patient's condition.

Across chronic respiratory conditions, we are exploring – and combining – a multitude of different pathways that could one day fill longstanding gaps in care.

For instance, in asthma, some patients exhibit potential evidence of mixed-type inflammation defined by both elevated neutrophils and eosinophils, which may add an additional layer of complexity to their care. Sanofi is exploring the potential of OX40-Ligand (OX40L), a key immune regulator¹², as a target to stop inflammation at its root.¹³ The OX40L pathway may potentially impact patients with mixed inflammation, and that which goes beyond just Type 2.¹⁴

We are also investigating the potential of an oral inhibitor of Bruton's tyrosine kinase (BTK) in asthma.¹³ We are analyzing its ability to potentially lead to future reduction in symptoms and loss of asthma control events, which may result in reduction in exacerbations for patients with asthma.

Furthermore, we are investigating an asset that combines targeting of interleukin-13 (IL-13) and thymic stromal lymphopoietin (TSLP), both potentially key drivers of the inflammation in respiratory diseases like asthma, COPD and CRSwNP.¹³ A goal of our research is to determine if the combination of these targets could create better outcomes for patients than with single targets.

As part of our ongoing partnership with Regeneron, we are also exploring the potential of targeting interleukin-33 (IL-33) across COPD and other respiratory diseases.¹³ IL-33 is thought to be involved in different types of inflammation.¹⁵

Sanofi leverages some of the best R&D technology in the form of artificial intelligence and data analysis platforms, patient-centric clinical trials and — most importantly — passionate scientists who drive our innovative spirit. Immunoscience is the bedrock of Sanofi’s research and development and enables us to apply deep biological pathway knowledge and expertise across different, often seemingly unrelated, therapeutic areas.

As we continue to chase the miracles of science and unlock the potential of the immune system, we remain driven not by what, but by who is at the center of everything we do: the patient.

“As we look ahead to the future of respiratory disease treatment, I’m inspired by new potential advancements in the space,” said Ashrafian. “They support our goal of lessening the burden of disease on patients, so they don’t have to think about their disease anymore.”