CHEST COPD Immersion June 2025-6. Biologics_Navigating Type 2 Inflammation in Asthma and COPD

6. Biologics_Navigating Type 2 Inflammation in Asthma and COPD

Pdf Summary

The document is a comprehensive exploration of Type 2 inflammation in the management of asthma and Chronic Obstructive Pulmonary Disease (COPD), with a focus on biologic treatments. J. Bourbeau from McGill University, who has conflicts of interest due to funding from several pharmaceutical companies, outlines the objectives of comparing inflammatory pathways and biologic therapies in these diseases.<br /><br />Type 2 inflammation in asthma is driven by various cytokines such as IL-4, IL-5, and IL-13, causing increased airway remodeling, decreased lung function, and heightened exacerbations. Biologic treatments targeting these cytokines are significant for patients with high blood eosinophils—biomarkers predicting treatment efficacy. Treatments like Omalizumab, Dupilumab, Mepolizumab, and Tezepelumab offer targeted therapy, reducing severe exacerbations significantly. Dupilumab, in particular, shows efficacy across primary and secondary outcomes, providing sustained lung function improvement and enhanced quality of life.<br /><br />In COPD management, despite triple inhaled therapy, many patients still face frequent exacerbations. COPD inflammatory pathways can be distinguished by unique mediators like IL-1, IL-6, and alarmins. Type 2 inflammation, marked by increased eosinophils and the presence of cytokines like IL-5, propels the efficacy of agents like Dupilumab and Mepolizumab. In clinical trials such as NOTUS, BOREAS, and MATINÉE, these biotherapeutics have demonstrated efficacy in exacerbation reduction, lung function improvement, and better health-related quality of life, particularly in patients with higher eosinophil counts and FeNO levels.<br /><br />There is an unmet need for tailored treatment strategies in COPD, where identifying treatable traits like type 2 inflammation is critical. The document emphasizes ongoing and future studies to enhance biologic therapies in asthma and COPD, suggesting significant potential for these treatments to mitigate the burden of these chronic inflammatory diseases.

Keywords

Type 2 inflammation

asthma

COPD

Chronic Obstructive Pulmonary Disease

biologic treatments

cytokines

eosinophils

Dupilumab

Mepolizumab

lung function

exacerbations