Biological Therapy in COPD Management: Current Evidence, Challenges and Opportunities

Abstract

The goals of COPD treatment are to improve symptoms and decrease future risks such as exacerbations, lung function decline and mortality. Despite receiving maximal inhaled treatment, many COPD patients continue to exacerbate. This highlights the need for novel therapeutic approaches. There is now positive clinical trial data supporting the use of monoclonal antibody treatments in COPD. There remain challenges to define responder populations for each monoclonal antibody class on the basis of clinical characteristics and biomarkers. There are considerable future opportunities, including the targeting of disease activity with monoclonal antibodies at earlier stages in the natural history of COPD in order to slow the rate of disease progression. Using monoclonal antibodies during an exacerbation as a targeted treatment also hold potential. Monoclonal antibody treatments have the potential to change the landscape of COPD management.

Keywords: COPD; Clinical trials; Dupilumab; Eosinophils; Exacerbations; IL-13; IL-33; IL-5; Monoclonal antibodies; TSLP; Type 2 inflammation.