Why Multidisciplinary Care Drives COPD Biologic Selection

Multidisciplinary approaches, particularly when treating patients with chronic obstructive pulmonary disease (COPD), are central to treatment strategies involving biologics, especially when patients have overlapping conditions.

Biologic options for patients with COPD or asthma are expanding, but 1 biologic in particular, dupilumab, was highlighted at the 2026 European Respiratory Society (ERS) International Congress in Barcelona, Spain. The monoclonal antibody is FDA approved to treat a variety of conditions and diseases, in addition to COPD, many of which overlap.¹ Deciding when and what biologic should be administered to patients with COPD requires the input of multiple specialists to address the varying levels and progression of disease or conditions a patient might have, Francesca Puggioni, MD, a pulmonary allergology specialist at Humanitas Research Hospital in Milan, Italy, and a speaker at ERS, said in an interview with The American Journal of Managed Care^®.

“We decide which is the best approach, and this allows us to understand which biologics and which dosage of biologics for which disease, and we train the patient on this situation,” she said.

Puggioni referenced a causal mediation analysis on the association between quality-of-life outcomes and downstream effects in patients with COPD taking dupilumab, presented at the American Thoracic Society International Conference by Surya Bhatt, MD, University of Alabama at Birmingham.¹

That analysis showed that improvements in patient-reported outcomes with dupilumab were driven by a combination of reduced exacerbation frequency, improved lung function, and declines in fractional exhaled nitric oxide levels.

“This methodology, I think, will be used in the future and could be useful to assess the total effect of a therapy and the relationship between therapy and disease,” Puggioni said.

She then pointed to older patients with COPD, emphasizing that the goal when treating them “is not only to achieve some milliliter more in FEV₁ but is to restore an equilibrium in a patient with a high level of systemic inflammation, [which is] typical of COPD patients.”

References

1. Couillard S, Chatt S, Rabe K, Martinez F, Bruselle G, Al-Ahmad M. Exploring new clinical data for dupilumab and itepekimab in COPD and asthma. Respir AMJ. 2026;4(1):42-53. doi:10.33590/respiramj/A3973834.