THE EFFICACY OF BIOLOGICAL TREATMENT METHODS IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS; SYSTEMATIC REVIEW

Background: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder characterized by airflow obstruction and persistent inflammation, result in frequent exacerbations and reduced quality of life. Patients with moderate to severe COPD continue to experience disease progression with regular treatments. Biologic therapies to a specific immune pathways were developed through the identification of eosinophilic and type 2 inflammatory phenotypes. This study aims to evaluate the efficacy and safety of biologic therapies to decrease exacerbations and improve clinical outcomes in patients with moderate to severe COPD. Methods: we conduct a systematic search in electronic databases (PubMed, Scopus, and Google Scholar) for randomized controlled trials (RCTs) published between 2014 and 2024. Studies included adult COPD patients (≥40 years) treated with biologics targeting IL-5, IL-4/13, IL-1, or TSLP. The Cochrane Risk of Bias 2 tool was used to assess study quality. Data extraction and screening were performed independently by two authors. Results: Seven RCTs were included, examining biologic treatrmet (dupilumab, mepolizumab, benralizumab, tezepelumab, and MEDI8968). Dupilumab reduce exacerbation rates and improved lung function and quality of life in patients with type 2 inflammation. Mepolizumab showed modest benefit in eosinophilic COPD. Other treatments, including benralizumab and tezepelumab, failed to demonstrate consistent clinical efficacy. Conclusion: Biologics treatment show a selective benefits in COPD patients with eosinophilic or T2-high inflammation, mainly with dupilumab. Further studies are needed to define optimal patient selection and assess long-term safety and cost-effectiveness.