As we move deeper into 2024, a major shift is taking place in the treatment of chronic obstructive pulmonary disease (COPD). The medical community is excited following the recent approval of dupilumab (Dupixent) by the US Food and Drug Administration (FDA) as a maintenance treatment for adults with inadequately controlled COPD, particularly those with an eosinophilic phenotype. This landmark approval, which came on September 27, 2024, makes dupilumab the first biological treatment for COPD, prompting a wave of optimism among pulmonologists and respiratory specialists.

Dr. Antonio Anzueto, a noted pulmonologist from UT Health San Antonio, expresses great enthusiasm about the potential impact of dupilumab. He highlighted the remarkable transformation he has seen in asthma patients treated with biological therapies and is hopeful that similar benefits will be observed in COPD patients. “We’re providing our patients with more opportunities to improve their quality of life,” said Dr. Anzueto.

The approval of dupilumab is part of a broader trend, with three new medications approved in 2024 alone and a total of nine new treatments over the past five years, positioning it as a key player in the treatment arsenal against COPD. The efficacy of dupilumab was demonstrated through two pivotal phase 3 trials: BOREAS and NOTUS.

BOREAS Trial Highlights

The BOREAS trial, which ran for 52 weeks across 275 sites in 24 countries, included 939 adults aged 40 to 80 years who were current or former smokers with significant eosinophil counts. The results were compelling, revealing a 30% reduction in instances of moderate or severe COPD exacerbations among patients receiving dupilumab compared to those on a placebo. Moreover, lung function, measured by the prebronchodilator FEV1, improved significantly in those treated with dupilumab, marking a difference of 160 mL over the placebo group by week 12—a difference that remained noteworthy throughout the trial.

NOTUS Trial Findings

The NOTUS trial followed suit, including 935 adults aged 40 to 85 years and validating the results of the BOREAS trial. Dupilumab treatment led to a 34% reduction in moderate or severe exacerbations over the course of the trial, alongside notable improvements in lung function and health-related quality of life.

Dr. Jean Wright, CEO of The COPD Foundation, articulated the desperate need for effective treatments for those suffering from inadequately controlled COPD. He noted that patients often face tremendous challenges in daily tasks such as walking or running errands due to symptoms like breathlessness and wheezing. With the approval of dupilumab, there is renewed hope for better disease management and an improved quality of life for these individuals.

As the medical community braces for the future, the introduction of dupilumab marks a significant advance in the fight against COPD. With ongoing research and new treatment options, there is optimism that more patients will benefit from tailored therapies aimed at better controlling their symptoms and enhancing their daily lives.