Advancing COPD management through novel pharmacological agents: ensifentrine and dupilumab.

Abstract

COPD is a progressive respiratory condition characterised by persistent airflow limitation and chronic inflammation. Despite advances in bronchodilator and corticosteroid therapy, many patients, particularly those with eosinophilic inflammation, remain inadequately managed. This review highlights two recently approved therapies, ensifentrine and dupilumab, which represent a shift toward precision medicine in COPD management. Ensifentrine, a dual phosphodiesterase 3 and 4 inhibitor, offers both bronchodilatory and anti-inflammatory effects, improving lung function and reducing exacerbations. Dupilumab targets interleukin-4 and interleukin-13 signalling, addressing type 2 inflammatory pathways prominent in eosinophilic COPD. Key clinical trials (ENHANCE, BOREAS, NOTUS) demonstrate the efficacy of these agents in improving forced expiratory volume in 1 s, reducing exacerbation rates, and enhancing quality of life in select patient subgroups. By focusing on disease endotypes, these novel therapies underscore the growing role of personalised treatment approaches in COPD. Continued investigation into biomarkers and long-term outcomes will be essential for integrating these therapies into routine clinical practice.