Biologics for COPD: What You Need to Know

This article was written by Arnelle Konde, MPH, CHES.

Managing COPD is not always easy. Sometimes it can seem like your COPD treatments are not working. If you are still dealing with symptoms or frequent flare-ups, you may have heard about a newer type of treatment called a biologic. Here we will break down what biologics are, how they work, and what you should know before talking to your doctor. We also want to hear from you—what have you heard about these treatments, and how can we help you learn more?

What are Biologic Treatments?

Biologic medications are different from the medicines you take for COPD. Most pills and inhalers are made in a lab with chemicals. Biologics are made from natural sources, like living cells or proteins.¹ While many medications affect your entire body, biologics work on one specific part of your immune system. This targeted approach may help reduce inflammation in a more effective way.¹

How do Biologics Work in COPD?

COPD symptoms may worsen over time because of inflammation of the lungs. This inflammation can be triggered when your body overreacts to things like dust, smoke, or infections. When this happens, your airways can become narrow and swollen, making it harder to breathe.

Biologic medications help reduce inflammation in the lungs. This can make it easier to breathe and help prevent flare-ups.² They work best for people with high levels of eosinophils, a type of white blood cell linked to inflammation.²

However, it's important to know that not everyone qualifies. Right now, only 1 out of 3 people living with COPD qualify for these medications based on their blood eosinophil count and history of flare-ups.³ Biologics are usually added to a treatment plan when other medicines are not enough to control symptoms.⁴ They work by calming down the parts of your immune system that trigger inflammation.

What Biologic Treatments are Available?

There are two FDA-approved treatment options available for people with COPD:⁴

• Dupixent (Dupilumab): Approved for COPD patients who have high levels of eosinophils
• Nucala (Mepolizumab): Another option recently approved for people who still have many flare-ups despite using their inhalers

Unlike inhalers that may be used every day, these treatments are usually given by injections every few weeks.⁴ Check with your doctor or pharmacist to learn how often you need the injection and how to take it safely. It is also helpful to know that more biologics are being studied for COPD, so more options may be available soon.

Are Biologics Right for You?

You may want to talk to your doctor if:

• You are using multiple inhalers and still struggle with managing symptoms.
• You have frequent flare-ups that require steroid pills (like prednisone) or hospital visits.
• Your doctor has mentioned high levels of eosinophils in your blood.

Your health care provider can help determine whether a biologic might be a good option for you.

What We Learned from Our Survey

Research on biologics for COPD is still new, and there is a lot that is still unknown. To understand what people living with COPD know about these treatments and what information they still need, we conducted an anonymous survey. Our goal was to identify knowledge gaps, common questions and concerns, and use those insights to develop educational resources that meet the needs of the COPD community.

Our survey of 903 respondents found that:

• 56% had never heard of biologic treatments before.
• 39% were unsure who may qualify for these medications.
• 71% were not confident they understood the process for getting biologic treatment.
• 66% wanted more information about how biologics work and how they differ from other COPD medications inhalers.
• 68% had questions about insurance coverage, cost, and the steps required to receive treatment.
• 54% were concerned about possible side effects and whether these medications would be right for them.

These results show a clear gap: while interest in biologics is growing, many people living with COPD still need clear, reliable information to help them understand their options.

Learning about new treatments can feel overwhelming, but having the right information can make it easier to have these conversations with your doctor. If you continue to have frequent flare-ups despite your current treatment, a biologic could be a helpful next step. Talk to your doctor to see if you qualify and if a biologic is right for you.