The management of COPD is in a new era. Triple therapy (ICS + LABA + LAMA) has been used over the years to form the backbone behind symptom reduction and exacerbation prevention. It is effective in most patients and particularly the ones with increased number of eosinophils, and it is also cost-effective and simple to administer.
However, now biologics are becoming the new breed, so the real game changer especially in patients with eosinophilic COPD still deteriorates despite the best inhaler therapy. Namely duplilumab and mepolizumab are agents that inhibit particular inflammatory routes and have demonstrated encouraging exacerbation decreases in chosen populations of patients.
Nonetheless, biologics also present a number of difficulties: they are too expensive, of limited supply, and only a minority of COPD patients can benefit.
What is the future of it then?
Precision medicine is becoming a new direction in the management of COPD-no biologics taking the place of inhalers but an added value to the appropriate patient.
In short:
Triple therapy remains the standard.
Add-ons in uncontrolled, eosinophilic COPD Biologics Add-ons into uncontrolled, eosinophilic COPD Biologics are add-ons to uncontrolled, eosinophilic COPD.
It is designed to address the future, which is personalized and evidence-based.
MBH/PS