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. 2025 Jan;155(1):219-222.e1.
doi: 10.1016/j.jaci.2024.09.019. Epub 2024 Oct 3.

Clinical effectiveness and safety of dupilumab in patients with chronic obstructive pulmonary disease: A 7-year population-based cohort study

Chuan-Yen Sun  1 , Yohannes Tesfaigzi  2 , Gin-Yi Lee  3 , Yi-Hsuan Chen  4 , Scott T Weiss  5 , Kevin Sheng-Kai Ma  6
Affiliations

Clinical effectiveness and safety of dupilumab in patients with chronic obstructive pulmonary disease: A 7-year population-based cohort study

Chuan-Yen Sun et al. J Allergy Clin Immunol. 2025 Jan.

Erratum in

  • Corrigenda.
    [No authors listed] [No authors listed] J Allergy Clin Immunol. 2025 Apr;155(4):1400. doi: 10.1016/j.jaci.2025.02.001. Epub 2025 Feb 10. J Allergy Clin Immunol. 2025. PMID: 39945701 No abstract available.

Abstract

Background: Previous randomized controlled trials have established the efficacy of dupilumab among patients with chronic obstructive pulmonary disease (COPD) treated with triple therapy over 52 weeks of follow-up.

Objective: This population-based cohort study aimed to explore the long-term safety and effectiveness of dupilumab in patients with COPD.

Methods: The study included US patients with COPD who were seen between April 2017 and August 2024. Patients initiating dupilumab and therapies that incorporated long-acting β2-agonist (LABA) inhalers were included. Patients with asthma or lung cancer were excluded. The risk of outcomes occurring after initiation of dupilumab versus LABA-containing therapies was measured. For detailed methods, please see the Methods section in this article's Online Repository at www.jacionline.org.

Results: A total of 1521 dupilumab initiators and 1521 propensity score-matched patients who were receiving LABA-based therapies were included. Receiving dupilumab was associated with lower all-cause mortality (hazard ratio [HR] = 0.53, 95% CI = 0.43-0.65), fewer emergency department visits (HR = 0.78, 95% CI = 0.69-0.89), and lower acute exacerbation rates (HR = 0.59, 95% CI = 0.53-0.65). Dupilumab was also associated with reductions in the requirement for short-acting β2-agonists (HR = 0.48, 95% CI = 0.43-0.52) and short-acting muscarinic antagonists (HR = 0.43, 95% CI = 0.37-0.49) for symptom control. Additionally, dupilumab decreased rates of subsequent pneumonia (HR = 0.65, 95% CI = 0.50-0.86), and COPD-relevant comorbidities, including new-onset heart failure (HR = 0.69, 95% CI = 0.53-0.90) and new-onset anxiety (HR = 0.70, 95% CI =0.53-0.93).

Conclusions: In patients with COPD, dupilumab was associated with a lower mortality rate, fewer emergency department visits, and a reduced risk of acute exacerbations, respiratory symptoms, and respiratory infections. More studies are needed to validate the efficacy of dupilumab among patients with COPD of various severities.

Keywords: COPD; acute exacerbations; anti–IL-13 receptor; anti–IL-4 receptor.

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Conflict of interest statement

Disclosure statement This study was supported by the National Heart, Lung, and Blood Institute (grant HL161362 [to S.T.W.]). Disclosure of potential conflict of interest: S. T. Weiss receives royalties from UpToDate and serves on the board of Histolix, a digital pathology company. The rest of the authors declare no relevant conflicts of interest.

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