Real-World Experience of Dupilumab Treatment for Patients with COPD - A Single Center Prospective Study.

Purpose: Dupilumab was recently shown to be effective in patients with chronic obstructive pulmonary disease (COPD) and type 2 inflammation, while real-world data are missing. We aimed to evaluate the experience of COPD patients treated with Dupilumab.

Patients and methods: Consecutive patients with COPD treated with Dupilumab were approached and completed a structured interview. Before treatment, all patients had blood eosinophil count ≥300 cells/μL and prior-year exacerbations despite triple inhaler therapy.

Results: Twenty-three subjects were included, with median (IQR) treatment of 320 (280-355) days, median age of 75 years, and 52% female. A decrease in mean annualize exacerbation rate was observed from 3.47 at baseline to 1.55 after treatment (55% reduction). Number of severe exacerbations decreased as well (median 1 vs 0 over the same time frame). There was a decrease in the median COPD assessment test scores (median of 18 vs 15), although FEV1 did not change. One patient had skin-related side effect. Sixty-one percent were content with the treatment, and 74% would recommend it to others with COPD. During interview, patients reported on their need and openness to new and safe treatment options. Using the Global Evaluation of Treatment Effectiveness (GETE) tool, 30% reported on marked improvements following dupilumab. Treatment limitations were costs (48%) and repeated injections (21%).

Conclusion: In this case-series, dupilumab was shown to be well tolerated and was associated with lower rates of exacerbations and improved symptoms. These outcomes were supported by patient reported outcome measurements.