Dupilumab Improves Lung Function, Type 2 Inflammation in COPD

In part two of an interview, Klaus Rabe, MD, PhD, chest physician and professor of medicine at the University of Kiel, discusses the potential of dupilumab as a therapeutic option for patients with chronic obstructive pulmonary disease (COPD) characterized by type 2 inflammation. He provides insight into the findings from the BOREAS trial, where patients experienced improvements in lung function, and explores the mechanisms that may have contributed to this outcome, including changes in mucus production and airway smooth muscle.

The results of the BOREAS trial were presented at The European Respiratory Society (ERS) International Congress, held September 7-11, 2024, in Vienna, Austria.

"The disease COPD is frequently characterized or described as being a disease where lung function is irreversibly damaged," Rabe explained in an interview with The American Journal of Managed Care^® (AJMC®). "Irreversibility is a relative term, and for some individuals who are very much impaired, even small changes in the lung volumes would probably make a difference."

In the BOREAS trial, the primary end point—reducing exacerbations in patients treated with dupilumab—was successfully achieved. According to Rabe, what stood out was the rapid improvement in lung function that occurred within 2 to 4 weeks, which was both surprising and clinically meaningful. He further emphasizes that the underlying mechanisms behind this rapid improvement, such as mucus plugging or smooth muscle reversibility, still require more investigation.

"We addressed change in lung function in this population who were already on 2 bronchodilators under triple therapy," Rabe added. "To see this was quite surprising. It was also surprising to see how rapidly this occurred."

These findings suggest that dupilumab could be an important new treatment option for patients who have COPD with type 2 inflammation, providing hope for those with severe lung impairment. Future research will likely focus on understanding the mechanisms driving these improvements.