COPD patients will get access to Dupixent via NHS

Almost 30,000 people in England with chronic obstructive pulmonary disease (COPD) could soon have access to a biologic treatment, Sanofi and Regeneron's Dupixent, after it was recommended for use by the NHS.

IL-4 and IL-13 inhibitor Dupixent (dupilumab) was approved in the UK in September 2024 as an add-on maintenance treatment for adults with uncontrolled COPD characterised by raised blood eosinophils, becoming the first targeted medicine for the progressive lung disease and ending a decade-long hiatus in new COPD therapies.

In final draft guidance, heath technology assessment (HTA) agency NICE has concluded that Dupixent can be prescribed for people living with COPD who are already having standard dual and triple respiratory therapy based on long-acting beta agonist (LABA) and long-acting muscarinic antagonist (LAMA), with and without inhaled corticosteroid (ICS) drugs.

Uncontrolled COPD means that they have had one or more severe exacerbations, the acute flare-ups that signal progression of the debilitating and irreversible disease, or two or more moderate exacerbations in the last 12 months.

Dupixent is self-administered every two weeks using an autoinjector, and in clinical trials has been shown to reduce flare-ups by around 30%, whilst also reducing the symptoms of breathlessness that have a severe impact on patients' quality-of-life and improving lung function scores.

"COPD flare-ups can be devastating, often requiring admission to hospital and steroid treatments that can have serious side effects," said the reimbursement authority, which estimates that the NHS deals with around 130,000 COPD-related emergency visits each year in England alone.

"Patient experts told NICE that flare-ups typically last one to two weeks and can be extremely debilitating, affecting people's ability to work and carry out daily activities."

COPD is the third leading cause of death worldwide, killing more than three million people a year, according to World Health Organization (WHO) figures, with a devastating impact on patients' lives. There are around 1.2 million people with a COPD diagnosis in the UK.

NICE has estimated that around 40% of people with COPD have elevated blood levels of eosinophils and, if half the eligible population were to be treated with Dupixent, there could be around 3,600 fewer COPD attacks, saving the NHS around £16.5 million per year.

"While not everyone will be eligible for this drug, this is the most important breakthrough in COPD care in nearly a decade," said Sarah Sleet, chief executive of patient organisation Asthma + Lung UK.

"This is the first ever targeted treatment for people with uncontrolled COPD and a major milestone," she added. "Now we need to improve wider COPD care and, subject to final guidance, ensure that everyone who could be helped by dupilumab is able to access it."

Earlier this year, GSK's IL-5 inhibitor Nucala (mepolizumab) was also approved for eosinophilic COPD in the UK, with a similar label to Dupixent.

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