Struggling to Get Your COPD Under Control? A New Drug Might Help

Key Takeaways

• The U.S. Food and Drug Administration has approved Dupixent (dupilumab) to reduce COPD exacerbations in some patients whose symptoms aren't adequately controlled with inhaled medicines.
• Dupixent is an "add-on" drug for COPD, meaning patients take it in addition to inhaled medication
• Dupixent isn't approved as a stand-alone treatment for COPD.

The U.S. Food and Drug Administration (FDA) has approved Dupixent (dupilumab) injections as an add-on therapy for certain adults with poorly controlled chronic obstructive pulmonary disease (COPD) .

The FDA cleared Dupixent for people with COPD who are also using inhaled COPD medications yet still have too many eosinophils. An important part of the immune system, eosinophils are a type of white blood cell that can cause inflammation in the lungs and exacerbate breathing problems. Dupixent is an "add-on" maintenance therapy that these patients can take in addition to inhaled medicines, said the drug's maker, Sanofi, in a statement.

Dupixent is a biologic drug, a newer class of medication made from living cells or components of living organisms, like proteins. It works by targeting parts of the immune system that contribute to chronic inflammatory diseases.

Sanofi says Dupixent is the first-ever biologic for COPD.

"People living with inadequately controlled COPD have long awaited new medicines to help manage the daily suffering they experience from breathlessness, coughing, wheezing, exhaustion, and unpredictable hospitalization," Jean Wright, MD, the chief executive officer at the COPD Foundation, said in the drugmaker's statement.

"These patients often struggle with everyday activities many people take for granted, such as taking a walk or running errands outside the home," Dr. Wright said in the statement. "We welcome the approval of this new therapeutic option to offer patients a new way to help gain better control of their disease."

When Inhaled Medications Aren't Doing Enough for COPD

People with COPD suffer from conditions that restrict the flow of air in the lungs and make it difficult to breathe. Most people have either emphysema , which happens when air sacs in the lungs called alveoli don't function properly, or chronic bronchitis - which happens when inflammation in the airways causes mucus to accumulate in the lungs.

Many patients with COPD take a combination of several medications to manage symptoms like chronic cough, tightness in the chest, wheezing, shortness of breath, and fatigue. In clinical trials reviewed by the FDA as part of the approval process, Dupixent was tested in people who were already taking two inhaled bronchodilators to open the airways and an inhaled steroid to reduce inflammation, or people who just used two bronchodilators because steroids weren't a good option for them.

"We have good medications for COPD and most patients respond and their shortness of breath improves and their ability to do things improve," says Nick Hanania, MD , a professor, the director of the airways clinical research center at Baylor College of Medicine in Houston, and a coauthor of research on the medication.

"However, about 40 to 50 percent of patients on these inhalers continue to experience exacerbation," Dr. Hanania says.

Dupixent Reduced Moderate to Severe COPD Exacerbations in Clinical Trials

In two late-stage clinical trials, current and former smokers with COPD had significantly fewer symptom exacerbations when Dupixent was added to a treatment regimen of two or three inhaled COPD medicines. All the patients also had lung inflammation confirmed by elevated blood levels of eosinophils. Both trials randomly assigned patients to take Dupixent or a placebo along with their regular treatment regimen for 52 weeks.

One trial found that those who took Dupixent for a year reduced moderate to severe COPD exacerbations by 14 percent, compared with a 30 percent increase on the placebo, according to findings published in the New England Journal of Medicine .

While about 68 percent of patients on Dupixent experienced side effects, this was similar to the side effect rate with the placebo. Similarly, the second yearlong trial found Dupixent reduced moderate to severe COPD exacerbations by 22 percent, compared with a 10 percent increase on the placebo, according to findings published in the New England Journal of Medicine . This trial also found the rate of side effects similar for Dupixent and the placebo.

These findings suggest that Dupixent may be a good add-on therapy for people who have high eosinophil levels that suggest inflammation in their lungs and who don't get enough symptom relief from COPD inhalers, says Hanania.

"In clinical trials, we demonstrated that this drug in this subpopulation decreases exacerbations and improves lung function and improves symptoms on top of existing therapies," Hanania says.

Editorial Sources and Fact-Checking

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy . We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Sources

1. Press Release: Dupixent Approved in the U.S. as the First-Ever Biologic Medicine for Patients With COPD. Sanofi . September 27, 2024.
2. Dupixent: Frequently Asked Questions. Sanofi and Regeneron Pharmaceuticals .
3. Bhatt S et al. Dupilumab for COPD With Blood Eosinophil Evidence of Type 2 Inflammation. New England Journal of Medicine . May 20, 2024.
4. Bhatt S et al. Dupilumab for COPD With Type 2 Inflammation Indicated by Eosinophil Counts. New England Journal of Medicine . May 21, 2023.

Meet Our Experts See Our Editorial Policy Meet Our Health Expert Network

Lisa Rapaport

Author

Lisa Rapaport is a journalist with more than 20 years of experience on the health beat as a writer and editor. She holds a master's degree from the UC Berkeley Graduate School of Journalism and spent a year as a Knight-Wallace journalism fellow at the University of Michigan. Her work has appeared in dozens of local and national media outlets, including Reuters, Bloomberg, WNYC, The Washington Post, Los Angeles Times , Scientific American , San Jose Mercury News , Oakland Tribune , Huffington Post, Yahoo! News, The Sacramento Bee , and The Buffalo News . See full bio See Our Editorial Policy Meet Our Health Expert Network