COPD is often considered an inflammatory disease caused primarily by neutrophilic inflammation, but it is increasingly recognized that a substantial proportion of COPD patients primarily have type 2 inflammation. Many eosinophils often detect this in the blood and are associated with a high risk of exacerbation. Notable about the ballyhoo, Late Breaking Abstract on Efficacy and Safety of Dupilumab for COPD with Type 2 Inflammation Indicated by Elevated Eosinophils and Oral NEJM/ERS Joint Journal Session on Dupilumab for COPD with Type 2 Inflammation Indicated by Eosinophil Counts from Sanofi and its collaborations will be presented at the International Congress of the European Respiratory Society (ERS) 2023 from September 9 to September 13 in Milan, Italy which has Dupixent (dupilumab) COPD data as a pivotal discussion.

COPD is an urgent global health concern and a notoriously difficult-to-treat disease due to its heterogeneity. The current COPD management is based on a “universal” approach and the available treatments aim to relieve symptoms and reduce the frequency of exacerbations, but do not change the course of the disease. Recent advances in molecular biology have deepened the understanding of the inflammatory pathways in the pathogenesis of COPD and led to the development of targeted (biological) therapies based on predetermined biomarkers. This has led to a continuous evolution in the COPD treatment landscape, with biologics around the corner.

Dupixent (Dupilumab) has the potential to become the first biologic for COPD following promising results in which it demonstrated a clinically meaningful and significant reduction in exacerbations. In the landmark Phase III trial, patients with uncontrolled COPD achieved clinical outcomes with Dupixent at a scale never seen before with biologics demonstrating a clinically meaningful and statistically significant 30% reduction in exacerbations, making it the first and only biosimilar with such results. With reduced exacerbations, patients with moderate to severe COPD experienced rapid and significant improvement in lung function, with a 160 mL increase in forced expiratory volume in one second (FEV1). Significant improvements in quality of life and respiratory symptoms in patients with evidence of type 2 inflammation treated dupilumab treatment have also been observed.

Understanding many COPD biologics, such as Duplimab, Mepolizumab, Benralizumab, and Tezepelumab, among others under development, has challenged the approval of COPD biologics. This is not the first time biologics have attempted to manage COPD, and several attempts have been made to introduce biologics in the COPD field. GSK’s Nucala (Mepolizumab) had difficulty getting rejected by the FDA, while AstraZeneca’s Fasenra (benralizumab) also failed to demonstrate efficacy in COPD-specific clinical trials. However, in recent years, the understanding of the effectiveness of biologics for COPD has evolved. COPD is the space of major players in the respiratory universe and with promising results, the Dupixent brand is about to prove itself in another important indication such as COPD. Dupixent met its primary endpoint and Sanofi is now highlighting the secondary benefits of improved lung function and quality of life that Dupixent can bring to patients.

In anticipation and apprehension, approving a treatment for COPD - the third leading cause of death worldwide - will create a huge market. With so many biologics in landfills, Duplimab is poised to be a game changer in the biologics segment by being the ultimate game changer. Based on DelveInsight’s “Chronic Obstructive Pulmonary Disease (COPD) - Market Insight, Epidemiology and Market Forecast – 2032”, the COPD market in 2022 was estimated to be USD 12.5 billion in the 7MM, which is likely to surge at a considerable CAGR in the forecast period. Given the size of the COPD market and the limited effective treatment options, every incoming treatment is crucial to transform the treatment paradigm.