Biologic Medicines for COPD: What They Are and Why to Use Them

This article was written by Jonnie Korinko, MSRC, RRT, RRT-ACCS.

People with COPD often cough, wheeze, and have trouble breathing. This happens because the airways or air sacs in their lungs swell and narrow.¹ About 20-30% of people with COPD have high levels of a type of blood cell called eosinophils.² This means they have inflammation in their lungs that may be making their COPD symptoms worse. Here's what happens:

Trigger

Something, like pollen, smoke, or pet dander, enters your body, and your immune system thinks that it could hurt you. These things aren’t harmful, but your immune system wants to protect you from them.²

Immune Response and Chain Reaction

Immune cells called Th2 cells activate. These cells send signals that tell your body to make more eosinophils. The eosinophils then move to the lungs and cause swelling and irritation.²

Symptoms

Inflammation in the lungs can cause more mucus and tightness in the chest for people with COPD.²

For people who have this type of inflammation, new medicines can help reduce swelling and make breathing easier.

What are biologics?

Biologics are medications made from biological substances. This means they are made from living things like cells and proteins from plants and animals. These medicines are more fragile than medicines made from chemicals, so there are usually important instructions on how to store them and take them safely.³

Many people use biologic medicines. Insulin was one of the first biologics developed and has been helping people for many years.

How do I know if a biologic could work for me?

If you have COPD symptoms even on your COPD treatment, talk to your health care provider to see what other treatments may help you breathe easier. For more about severe and worsening COPD, visit our webpage with resources.

Right now, there are two biologics available for people with COPD:

• Dupixent (Dupilumab). Dupixent was the first biologic medicine approved for people with COPD who still have inflammation and symptoms even after treatment. It is used with other COPD medicines.
• Nucala (Mepolizumab). Nucala was recently approved for people with COPD who have inflammation and COPD symptoms while on treatment. It is also used in combination with other COPD treatments.

These medicines are new, and there are new biologic medicines that may be available soon.

1. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for prevention, diagnosis and management of COPD: 2025 Report. [accessed 2025 July]. Available from: https://goldcopd.org/2025-gold-report/
2. Singh D, Kolsum U, Brightling CE, et al. Eosinophilic inflammation in COPD: prevalence and clinical characteristics. Eur Respir J. 2014;44(6):1697-1700. doi:10.1183/09031936.00162414
3. In brief: Biologics and Biosimilars. InformedHealth.org [Internet]. February 8, 2023. Accessed July 18, 2025. https://www.ncbi.nlm.nih.gov/books/NBK499546/