ROMEO is a Phase III, multicentre, open-label, chronic-dosing extension study evaluating the long-term safety of two dose regimens of tozorakimab in participants with COPD and a history of exacerbations.

Eligible participants must have completed one of the predecessor studies.

Inclusion Criteria:

1. Participants previously randomized in predecessor studies.
2. Participants should be affiliated with the French Social Security system.
3. Participants who are willing to continue using contraceptive methods as agreed to for the predecessor studies.
4. Capable of giving signed informed consent.

Exclusion Criteria:

1. Clinically important pulmonary disease other than COPD.

2. Participant meeting criteria for IP discontinuation as judged by the Investigator or the Sponsor.

3. Current alcohol, drug or chemical abuse.

4. Treatment with systemic corticosteroids or other immunosuppressive medication within 2 weeks prior to Visit 1 of ROMEO.

5. Known history of:

   1. Severe allergic reaction to any monoclonal and polyclonal antibody.
   2. Allergy or reaction to any component of the IMP formulation.

6. Receipt of blood products or immunoglobulins within 30 days prior to visit 1 of ROMEO.

7. Receipt of live attenuated vaccines within 30 days prior to visit 1 of ROMEO.

8. Chronic use (or expected need for chronic use during the study) of immunosuppressive medications (including, but not limited to, systemic corticosteroids), marketed or investigational biologic, or another prohibited medication.

9. Chronic use of antibiotics if the duration of treatment is < 3 months prior to Visit 1 of ROMEO (first IMP administration). Chronic macrolide or other antibiotic therapy is allowed provided the participant has been on a stable dose/regimen for ≥ 3 months prior to Visit 1 of ROMEO (first IMP administration) and has had at least one COPD exacerbation while on stable therapy.

10. Use of allergen immunotherapy within 3 months of Visit 1 of ROMEO (first IMP administration), except for stable maintenance dose allergen-specific immunotherapy started 4 weeks prior to V1.

11. Use of interferon gamma within 3 months of visit 1 of ROMEO (first IMP administration).

12. Participation in any interventional clinical trial or receipt of any investigational non-biologic product within 30 days or 5 half-lives prior to Visit 1 of ROMEO (first IMP administration), whichever is longer.

13. Involvement in the planning and/or conduct of the study (applies to both staff employed by the Sponsor and/or staff at the study site).

14. Participants who are not able to comply with the study requirements, procedures, and restrictions.

Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment:

https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.

Yes, indicates that AZ are accepting requests for IPD, but this does not mean all requests will be shared.

AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA/PhRMA Data-Sharing Principles. For details of our timelines, please refer to our disclosure commitment at :

https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.

When a request has been approved AstraZeneca will provide access to the anonymized individual patient-level data via secure research environment Vivli.org. A Signed Data Usage Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information.