How effective is Dupixent for COPD?

Dupixent (dupilumab) became the first biologic therapy approved by the FDA in 2024 for adults with chronic obstructive pulmonary disease (COPD) who have inadequately controlled symptoms and evidence of type 2 inflammation, specifically those with an eosinophilic phenotype. This approval marks a significant advancement for the estimated 300,000 U.S. adults with this form of COPD. In this article, we will review how effective Dupixent is for COPD and what you can expect.

How Dupixent Works

Dupixent is a monoclonal antibody that targets and blocks the activity of interleukin-4 (IL-4) and interleukin-13 (IL-13), two key drivers of type 2 airway inflammation. By inhibiting these pathways, Dupixent reduces inflammation in the lungs, which is particularly relevant for patients with elevated eosinophil counts (a type of white blood cell involved in inflammation). It is used as an add-on maintenance therapy—meaning it is taken alongside standard inhaled medications, not as a rescue treatment for sudden symptoms. The goal is to reduce the frequency of COPD flare-ups (exacerbations) and improve lung function over time.

Clinical Trial Data: NOTUS and BOREAS

The effectiveness of Dupixent for COPD is supported by two large Phase 3 clinical trials: NOTUS and BOREAS, both published in the New England Journal of Medicine.

Key Results

• Exacerbation Reduction: Dupixent reduced the rate of moderate or severe COPD exacerbations by 30–34% compared to placebo over 52 weeks.
• Lung Function: Patients receiving Dupixent experienced greater improvements in lung function, measured by forced expiratory volume in one second (FEV1). Improvements were seen as early as 12 weeks and maintained through one year.
• Quality of Life: Participants reported better symptom control and quality of life, as measured by validated questionnaires, compared to those on placebo.
• Safety: The safety profile was generally favorable, with side effects similar to placebo. The most common side effects include injection site reactions, cold-like symptoms, headache, and rare cases of increased eosinophil counts or joint pain.

New Evidence: 7-Year Population-Based Cohort Study

A 7-year, population-based cohort study published in 2025 provides important real-world evidence on the long-term effectiveness and safety of Dupixent in patients with COPD. This study included 1,521 patients who initiated Dupixent and compared them to 1,521 matched patients receiving long-acting β2-agonist (LABA)-based therapies, excluding those with asthma or lung cancer.

Key Findings

• Lower Mortality: Patients taking Dupixent were 47% less likely to die from any cause compared to those not taking the medication.
• Fewer Emergency Visits: Patients on Dupixent had fewer emergency department visits.
• Reduced Exacerbations: Patients taking Dupixent were about 41% less likely to have COPD flare-ups compared to those not taking the medication.
• Less Need for Rescue Medications: Dupixent users required fewer short-acting β2-agonists and muscarinic antagonists.
• Lower Rates of Pneumonia and Comorbidities: The study found reduced rates of subsequent pneumonia, new-onset heart failure, and new-onset anxiety with Dupixent.

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Who Benefits Most From Dupixent?

For COPD, Dupixent is specifically indicated for adults with inadequately controlled eosinophilic COPD. Ideal candidates for treatment include those with:

• Elevated blood eosinophils: Ideal candidates have blood eosinophil counts of at least 300 cells/µL, indicating type 2 inflammation.
• Frequent exacerbations: Patients who continue to have flare-ups despite being on maximal inhaled triple therapy (inhaled corticosteroid, long-acting beta-agonist, and long-acting muscarinic antagonist).

Dupixent is not recommended for patients whose COPD is not driven by type 2 inflammation or who have low eosinophil counts.

How Long Does Dupixent Take to Work?

Improvements in lung function and symptoms can begin within the first month of treatment, with significant benefits typically observed by 12 weeks. Full effects, including sustained reduction in exacerbations and improved quality of life, are generally seen over 6–12 months of continued therapy.

Limitations and Considerations

While Dupixent offers a promising new approach for certain adults with COPD, it is important to understand its limitations. This medication is not a cure for COPD, nor is it intended to replace rescue inhalers or other standard treatments for sudden breathing problems. Instead, Dupixent is used as an add-on maintenance therapy for a specific group of patients—those with type 2 inflammation and frequent exacerbations despite maximal inhaled therapy.

Additionally, patients and caregivers should also be aware of potential side effects and the need for ongoing use alongside other COPD medications. It is also important to understand cost or insurance barriers associated with biologic therapies. As a biologic, Dupixent is typically covered under specialty drug tiers, which may involve higher out-of-pocket costs and require insurance approval.

Summary

Dupixent represents a significant new option for adults with COPD characterized by type 2 inflammation and frequent exacerbations despite standard therapy. Its effectiveness is supported by robust clinical trial data and long-term real-world evidence showing meaningful reductions in exacerbations, improved lung function, better quality of life, and lower mortality. However, careful patient selection is essential, and Dupixent should be considered as part of a comprehensive COPD management plan. Patients should consult their healthcare provider to determine if Dupixent is appropriate for their specific situation.

This is not all the information you need to know about Dupixent (dupilumab) for safe and effective use and does not take the place of your doctor’s directions. Review the full patient medication guide and discuss this information and any questions you have with your doctor or other health care provider.

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Drug information

• Dupixent Information for Consumers
• Dupixent prescribing info & package insert (for Health Professionals)
• Side Effects of Dupixent (detailed)
• Dupixent user reviews (514)

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