Dr Surya Bhatt Discusses the Role of Dupilumab in Type 2 Inflammation, Exacerbations in COPD


Surya Bhatt, MD, associate professor of medicine at University of Alabama at Birmingham, talks about a new trial in which dupilumab was used in patients with chronic obstructive pulmonary disease (COPD) with frequent exacerbations and type 2 inflammation.

Patients with chronic obstructive pulmonary disease (COPD) who also exhibit type 2 inflammation and exacerbations were sought for a trial using dupilumab, said Surya Bhatt, MD, associate professor of medicine at University of Alabama at Birmingham. The study, “Dupilumab for COPD with Type 2 Inflammation Indicated by Eosinophil Counts,” was presented recently at the American Thoracic Society (ATS) International Conference.


Dupilumab is already approved for other indications—can you summarize how it works and why it is being tested for COPD?

Dupilumab is a humanized monoclonal antibody that targets the [interleukin] IL-4 alpha receptor, which is integral to both IL-4 as well as IL-13, and that way it blocks both IL-4 and IL-13 which are very critical for type 2 inflammation in patients with COPD. It's been increasingly recognized that about 20 to 40% of patients with COPD have type 2 inflammation, and they're more likely to suffer from repeated exacerbations. That is the reason why we're targeting patients with COPD with frequent exacerbations and type 2 inflammation with dupilumab.

Who was the patient population in the BOREAS trial of dupilumab and what type of COPD did they have?

BOREAS targeted patients with COPD with type 2 inflammation, and the main inclusion criterion were patients who were current or former smokers with at least a 10 pack/year smoking history and at high exacerbation risk, which was defined as at least 2 moderate exacerbations or 1 severe exacerbation in the previous year. And, they had to have an eosinophil count of at least 300 cells per microliter in the blood to be eligible.

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