China Securities Co., Ltd.: Chinese pharmaceutical companies have engineering advantages, and it is recommended to focus on the leading innovative drugs for asthma and COPD.

China Securities Co., Ltd. released a research report stating that the heterogeneity of asthma and COPD determines the precise stratification of type 2 inflammation pathways (from EOS300 to T2-low) and personalized treatment driven by biomarkers is the prerequisite for realizing the value of biologics; the industry presents a trend of "long-acting single-target" (such as once every six months IL-5 inhibitors) and "multi-target synergistic" (TSLP/IL-13 dual antibodies) technological iteration, while the heterogeneity of COPD has given rise to a dual-mainstream pattern of PDE3/4 inhalants and biologics existing simultaneously. The company believes that Chinese pharmaceutical companies with leading and in-depth layouts of targets such as IL-4R, TSLP, PDE3/4, IL5, and their combinations, as well as engineering advantages in long-acting technologies, are likely to achieve a leap from following to leading. It is recommended to pay attention to leading companies with long-acting technologies and deep layouts of new target points and combinations based on biological research. Main viewpoints of China Securities Co., Ltd.: Asthma and COPD: Mechanisms of T2 inflammation pathway overlap and phenotypic stratification Although asthma and COPD share the T2 inflammation pathway, the former is mainly driven by Th2 allergy, with reversible airflow restriction, while the latter exhibits a mixed inflammation of Th1/Th17 and Th2, with irreversible airway remodeling; the therapeutic heterogeneity requires precise stratification based on biomarkers such as blood eosinophils and FeNO. The synergistic and compensatory mechanisms of upstream alarmines (TSLP/IL-33) and downstream cytokines (IL-4/IL-5) form the underlying logic of biologics development. Asthma: Moving towards biologic treatment and long-acting/multi-antibody iteration, restructuring a new precise anti-inflammatory pattern Biologics for asthma are undergoing a paradigm shift from severe-to-moderate patients towards the front line of moderate patients; the IL-4R target has become the main competition track for domestic companies after the verification of the value of dual pathway blockade by Dupilumab. Technological iterations clearly point towards long-acting and multi-antibody synergy; GSK's Depemokimab achieves semi-annual dosing, while Sanofi's Lunsekimig and others block TSLP/IL-13, showing better control of FeNO and eosinophilic granulocytes than single-target agents. In addition, TSLP monotherapy covers non-type 2 inflammation, making it the only biologic agent not limited by phenotype. The ST2/IL-33 target is still being explored for its clinical value in the T2-low population, showing a trend of upgrading from "stepwise treatment" to "precise early intervention." COPD: Targeted stratification and inhalant innovation, precise stratified treatment and broad-spectrum anti-inflammatory treatment running in parallel The treatment of COPD has entered the era of dual-track parallelism of "precision biologics + new mechanism inhalants". Dupilumab, as the first approved biologic agent, has verified the value of IL-4R in patients with eosinophils (300/L), highlighting the necessity of strict stratification due to limited efficacy of IL-5 and the failure of IL-5RIII Phase III. TSLP and IL-33 targets are attempting to break through the bottleneck of non-type 2 inflammation by lowering the eosinophil threshold or covering the smoking population. Dual antibodies such as TSLP/IL-13 have entered Phase II/III to address disease heterogeneity. At the same time, the dual PDE3/4 inhibitor Ensifentrine fills the treatment gap for non-type 2 patients (about 70%) with a dual mechanism of bronchodilation and anti-inflammatory properties. Investment advice The company believes that Chinese pharmaceutical companies with leading and in-depth layouts of targets such as IL-4R, TSLP, PDE3/4, IL5, and their combinations, as well as engineering advantages in long-acting technologies, are likely to achieve a leap from following to leading. It is recommended to pay attention to leading companies with long-acting technologies and deep layouts of new target points and combinations based on biological research, as well as leading companies with high-barrier inhalants. Related companies include Jiangsu Hengrui Pharmaceuticals, INNOVENT BIO, Joincare Pharmaceutical Group Industry, SINO BIOPHARM, Haisco Pharmaceutical Group, AKESO, Canonova, Maiwei Bio, Zhejiang Huahai Pharmaceutical, etc. Risk warning: risks of approval delays, industry policy risks, risks of research and development falling short of expectations, risks of sales falling short of expectations, risks of intensified market competition.