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Short-Term Effects of Dupilumab in Eosinophilic COPD

Title: Short-Term Effects of Dupilumab in Eosinophilic COPD
Authors: Chiara Lupia; Daniela Pastore; Giuseppina Marrazzo; Giada Procopio; Antonio Giacalone; Federica Marrelli; Mariarosanna De Fina; Adele Emanuela De Francesco; Alessandro Vatrella; Santi Nolasco; Raffaele Campisi; Nunzio Crimi; Claudia Crimi; Girolamo Pelaia; Corrado Pelaia
Source: Journal of Clinical Medicine ; Volume 15 ; Issue 2 ; Pages: 775
Publisher Information: Multidisciplinary Digital Publishing Institute
Publication Year: 2026
Collection: MDPI Open Access Publishing
Subject Terms: chronic obstructive pulmonary disease; eosinophilic COPD; dupilumab; type 2 inflammation; clinical practice
Description: Background/Objectives: Patients with eosinophilic chronic obstructive pulmonary disease (COPD) often remain symptomatic despite optimized triple inhaled therapy. Dupilumab is a fully human monoclonal antibody that blocks the IL-4 receptor alpha subunit, thereby inhibiting IL-4 and IL-13 signaling. Evidence from randomized trials supports dupilumab for add-on treatment of type 2-high COPD, but data referring to short-term effectiveness in clinical practice are quite limited. Methods: We conducted an observational, compassionate-use study enrolling 13 consecutive outpatients with eosinophilic COPD (blood eosinophils ≥ 300 cells/µL) receiving add-on biologic therapy with dupilumab 300 mg every two weeks. Clinical (CAT, mMRC), functional (spirometry and body plethysmography), and inflammatory parameters (blood eosinophils/basophils, fibrinogen, FeNO) were evaluated at baseline and after four weeks of treatment. Safety was monitored after injection in a clinical setting, as well as via weekly phone follow-up. Results: Participants (84.6% male; mean age 67.08 ± 11.42 years) experienced rapid and clinically meaningful improvements at four weeks. CAT score decreased from baseline 21.40 ± 6.22 to 14.00 ± 5.58 (p < 0.001) and mMRC scale from 2.90 ± 0.73 to 1.80 ± 0.63 (p < 0.0001), respectively. Pre-bronchodilator FEV1 increased from baseline 1.35 ± 0.65 L to 1.59 ± 0.84 L (p < 0.05), and FVC from 2.36 ± 0.92 L to 2.83 ± 1.11 L (p < 0.01). A marked lung deflation was observed: indeed, residual volume declined from baseline 4.17 ± 1.98 L to 3.47 ± 2.07 L (p < 0.05), with a concomitant reduction in specific effective airway resistance (from baseline 3.15 ± 1.77 to 2.43 ± 1.44 kPa·s; p < 0.05) associated with significant increases in mid-expiratory flow (FEF25−75: from baseline 0.62 ± 0.38 to 0.86 ± 0.71 L/s; p < 0.05) and peak expiratory flow (3.80 ± 1.40 to 4.48 ± 1.79 L/s; p < 0.01). Type 2 inflammatory biomarkers changed as follows: blood eosinophil count fell from baseline 390.0 ± 43.75 to 190.0 ...
Document Type: text
File Description: application/pdf
Language: English
Relation: Respiratory Medicine; https://dx.doi.org/10.3390/jcm15020775
DOI: 10.3390/jcm15020775
Availability: https://doi.org/10.3390/jcm15020775
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.EBA9F35E
Database: BASE