CompEx a novel composite score of endpoints that are meaningful to people living with asthma or COPD and to clinical researchers including:
Symptoms, lung function, rescue medication and exacerbation events. CompEx was developed by an international team of researchers led by AstraZeneca.

Asthma

  1. Use of CompEx in eosinophilic patients with severe, uncontrolled asthma on benralizumab.  Bolton C, Harrison T, Lugogo N, Fuhlbrigge A, Hirsch I, Bengtsson T, Peterson S, Sidaway M, Garcia Gil E, Fagerås M, Da Silva CA. ERJ Open Res. 2024 Mar 18;10(2):01025-2023. doi: 10.1183/23120541.01025-2023. eCollection 2024 Mar. PMID: 38500798. Free PMC Article
  2. Impact of season and geography on CompEx Asthma: a composite end-point for exacerbations.  Jauhiainen A, Scheepers LEJM, Fuhlbrigge AL, Harrison T, Zangrilli J, Garcia Gil E, Gustafson P, Fagerås M, Da Silva CA. ERJ Open Res. 2020 Oct 19;6(4):00246-2020. doi: 10.1183/23120541.00246-2020. eCollection 2020 Oct. PMID: 33123561. Free PMC Article
  3. A novel endpoint for exacerbations in asthma to accelerate clinical development: a post-hoc analysis of randomised controlled trials.  Fuhlbrigge AL, Bengtsson T, Peterson S, Jauhiainen A, Eriksson G, Da Silva CA, Johnson A, Sethi T, Locantore N, Tal-Singer R, Fagerås M. Lancet Respir Med. 2017 Jul;5(7):577-590. doi: 10.1016/S2213-2600(17)30218-7. Epub 2017 Jun 2. PMID: 28583396  Clinical Trial.
  4. Comparison of the novel CompEx asthma exacerbation endpoint to the ATS/ERS adapted moderate/severe asthma exacerbation definition used in the MITRA trial.  Eriksson G, Nolte H, Ljørring C, Riis B, Virchow JC. Respir Med. 2019 Jul;153:1-2. doi: 10.1016/j.rmed.2019.04.014. Epub 2019 May 1. PMID: 31136926 
    Clinical Trial.
  5. An Update on Patient-Reported Outcomes in Asthma.  Wu TD, Diamant Z, Hanania NA. Chest. 2024 May;165(5):1049-1057. doi: 10.1016/j.chest.2024.02.010. Epub 2024 Feb 15. PMID: 38365175
  6. Wilkinson TMA, Akuthota P. CompEx Asthma: is it time for a change in clinical trials?. Eur Respir J. 2025;66(3):2500470. Published 2025 Sep 25. doi:10.1183/13993003.00470-2025
  7. Corren, Jonathan et al. “FRONTIER-3: a randomised phase 2a study to investigate tozorakimab, an anti-interleukin-33 monoclonal antibody, in early-onset asthma.” ERJ open research vol. 12,1 00183-2025. 23 Feb. 2026, doi:10.1183/23120541.00183-2025
  8. Hung, Chun-Tse et al. “Mirror, mirror on the wall: is CompEx the fairest endpoint of all?.” ERJ open research vol. 12,1 01258-2025. 23 Feb. 2026, doi:10.1183/23120541.01258-2025
  9. Bolton, Clare et al. “Clinical relevance of CompEx Asthma and impact on disease trajectory: benralizumab effect.” ERJ open research vol. 12,1 00486-2025. 23 Feb. 2026, doi:10.1183/23120541.00486-2025
  10. Mustapa, Mohd Nubli et al. “Phase 2a randomised, double-blind, placebo-controlled study to evaluate the efficacy and safety of londamocitinib (AZD4604) two times per day for 12 weeks in adult patients with moderate-to-severe asthma uncontrolled on medium-high-dose ICS-LABA.” BMJ open respiratory research vol. 13,1 e003589. 6 Mar. 2026, doi:10.1136/bmjresp-2025-003589

COPD

  1. COPDCompEx: A novel composite endpoint for COPD exacerbations to enable faster clinical development.  Vogelmeier CF, Fuhlbrigge A, Jauhiainen A, Scheepers LEJM, Bengtsson T, Peterson S, Karlsson N, Sethi T, Locantore N, Tal-Singer R, Rennard S, Fagerås M, Da Silva CA. Respir Med. 2020 Nov;173:106175. doi: 10.1016/j.rmed.2020.106175. Epub 2020 Sep 28. PMID: 33032168
  2. Treatment Trials in Young Patients with Chronic Obstructive Pulmonary Disease and Pre-Chronic Obstructive Pulmonary Disease Patients: Time to Move Forward.  Martinez FJ, Agusti A, Celli BR, Han MK, Allinson JP, Bhatt SP, Calverley P, Chotirmall SH, Chowdhury B, Darken P, Da Silva CA, Donaldson G, Dorinsky P, Dransfield M, Faner R, Halpin DM, Jones P, Krishnan JA, Locantore N, Martinez FD, Mullerova H, Price D, Rabe KF, Reisner C, Singh D, Vestbo J, Vogelmeier CF, Wise RA, Tal-Singer R, Wedzicha JA. Am J Respir Crit Care Med. 2022 Feb 1;205(3):275-287. doi: 10.1164/rccm.202107-1663SO. PMID: 34672872. Free PMC Article
  3. Clinical Meaningfulness of the Composite Endpoint, COPDCompEx, in Defining Exacerbations and Worsening of COPD: A Post Hoc Analysis of 4 Clinical Interventional Studies of COPD. Tal-Singer R, Vogelmeier CF, Bolton C, Bengtsson T, Peterson S, Sidaway M, Da Silva CA. Int J Chron Obstruct Pulmon Dis. 2026;21:603089
  4. Hughes, Rod et al. “Phase 2a, Randomized Trial of Mitiperstat Versus Placebo in Patients with COPD at High Risk of Exacerbation (CRESCENDO).” International journal of chronic obstructive pulmonary disease vol. 20 3305-3315. 24 Sep. 2025, doi:10.2147/COPD.S524775

In 2024, the Respiratory Innovative Respiratory Endpoints (IREN) team focused on CompEx asthma and developed the infographic below: