Regeneron Pharmaceuticals Inc and Sanofi SA's Dupixent (dupilumab) has received FDA approval for chronic obstructive pulmonary disease (COPD), representing a significant advancement in treating this condition, especially for smokers. This marks Dupixent's sixth U.S. indication and positions it as the first targeted therapy for COPD, a progressive lung condition characterized by obstructed airflow.
COPD, often a result of prolonged exposure to irritants like cigarette smoke, air pollution, or occupational dust, includes conditions like chronic bronchitis and emphysema. A 2023 analysis indicated approximately 44 million diagnosed cases across seven major markets, with a projected growth rate of 1.4% CAGR through 2034.
Current COPD Management and Unmet Needs
Typical COPD management involves bronchodilators, which relax airway muscles to ease breathing. These include short- and long-acting bronchodilators like Albuterol, Ipratropium, and Aclidinium, as well as combinations such as LABA+ICS (e.g., AstraZeneca’s Symbicort, GSK’s Advair) and LABA+LAMA (e.g., GSK’s Anoro Ellipta, Boehringer Ingelheim’s Stiolto Respimat). However, these treatments do not target the underlying inflammation in all COPD patients.
The introduction of Dupixent addresses this unmet need by specifically targeting type 2 inflammation pathways, namely IL-4 and IL-13, which are implicated in COPD patients with elevated eosinophils who are prone to frequent exacerbations.
Clinical Trial Data and Efficacy
The Phase 3 BOREAS trial demonstrated that Dupixent reduced moderate-to-severe exacerbations by 30% over 52 weeks. Furthermore, it improved lung function, with prebronchodilator FEV1 increasing by 160 mL compared to 77 mL in the placebo group. The drug also exhibited a favorable safety profile, suggesting its potential as a significant advancement for those with type 2 inflammation.
Future Directions in COPD Treatment
In addition to Dupixent, several mid-stage drugs are in development, including Sanofi/Regeneron’s itepekimab, AstraZeneca’s benralizumab, Amgen/AstraZeneca’s tezepelumab, and GSK’s mepolizumab. These drugs promise to offer more options and further transform COPD management, addressing various aspects of the disease and potentially improving patient outcomes.
