First UK patients receive targeted COPD injection
Dupilumab is being used at St Thomas’ Hospital for a COPD subtype linked to eosinophils, with trials showing fewer flare-ups.
By Priya Raghavan · Science Reporter
3 min read
Patients in the UK have received dupilumab for chronic obstructive pulmonary disease for the first time, according to King’s College London. The injection adds a targeted option for some people with COPD, a long-term lung disease that can cause severe breathlessness and repeated flare-ups.
King’s said patients at Guy’s and St Thomas’ NHS Foundation Trust began treatment at St Thomas’ Hospital after the drug was approved by the National Institute for Health and Care Excellence earlier this year. Dupilumab is intended for a subtype of COPD associated with eosinophils, a type of white blood cell.
COPD places a heavy burden on patients and the health service. King’s said 85 people with the condition die each day in the UK, citing Asthma and Lung UK, and that COPD costs the NHS about £2 billion a year and is the second-leading cause of hospital admissions.
Existing COPD medicines include bronchodilators, which help open the airways, and inhaled steroids, which reduce inflammation more broadly. King’s said those treatments do not directly target the inflammatory pathway involved in this form of COPD, and steroid inhalers can work unevenly across patients.
How the treatment works
Dupilumab acts on inflammatory proteins including IL-4 and IL-13, according to King’s. By blocking those signals, the drug is designed to reduce airway swelling and mucus buildup, which can make breathing easier and lower the risk of acute worsening.
King’s said clinical trials found dupilumab cut COPD exacerbations by 30% to 34% a year. Exacerbations can bring increased breathlessness, coughing and mucus, and may require steroids, hospital care or other treatment; in severe cases, they can be fatal.
The eosinophil-linked COPD subtype affects about 80 million people worldwide, according to King’s. Professor Mona Bafadhel, NIHR research professor and director of the King’s Centre for Lung Health, has studied eosinophils in COPD for two decades and was among the early researchers to identify their role, the university said.
Bafadhel said researchers still do not know the exact role eosinophils play in COPD, but patients with this form of inflammation often have more flare-ups. She said identifying those patients allows doctors to use more precise treatments that block the relevant inflammatory response.
Patients to be monitored for a year
King’s said patients will receive dupilumab every two weeks after the first injection and will be taught to self-inject from the second dose. The drug can be given with a pen device similar to those used by people with diabetes to take insulin.
Patients will be followed for the next year, with symptoms reviewed to assess whether the medicine is helping. If they improve, King’s said treatment will continue longer term.
The first patient treated was Patrick Regan, 67, from Catford, who was diagnosed with COPD about 15 years ago. Regan said, according to King’s, that he hoped the drug would help his breathing and allow him to do more with his children and grandchildren.
Dr. Amy Dewar, consultant in integrated respiratory medicine at Guy’s and St Thomas’ and lead for COPD, said the treatment opens a new route for COPD care and could reduce admissions and flare-ups. Helen Knight, director of medicines evaluation at NICE, said the recommendation marked a significant step because the drug offers a targeted therapy that has shown fewer flare-ups and better lung function.
This story draws on original reporting from Medical Xpress.