Targeted therapy as a new perspective in the treatment of COPD

Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition characterized by persistent airflow limitation caused by chronic airway inflammation in response to harmful particles and gases. The diversity of clinical manifestations and pathophysiological mechanisms necessitates an individualized approach to treatment. The disease is driven by inflammatory processes, including the activation of macrophages, neutrophils, and T-cells, as well as the release of various inflammatory mediators that contribute to chronic airway damage. In recent years, attention has turned to eosinophilic inflammation, traditionally associated with asthma, which is also found in a significant portion of COPD patients. Eosinophilia is observed in a considerable number of COPD patients and is associated with more severe disease and an increased risk of exacerbations. However, data on the role of eosinophils in COPD are mixed: some studies find no difference in disease severity between high- and low-eosinophil groups, while others confirm an elevated risk of exacerbations in patients with high eosinophil levels. A promising therapeutic agent in this area is dupilumab — a monoclonal antibody that blocks interleukin-4 and -13 receptors, demonstrating the ability to reduce exacerbation frequency and improve lung function in COPD patients by targeting eosinophilic inflammation. Clinical trial results indicate that dupilumab provides significant clinical improvement and may become an important tool in treating eosinophilic COPD, offering a new approach based on the molecular understanding of the disease. This publication presents the latest data on the use of dupilumab in COPD treatment.