New Respiratory Treatments Reshape Asthma and COPD Care

Advances in respiratory medicine are transforming asthma and chronic obstructive pulmonary disease (COPD) management, moving away from generalized treatments to personalized approaches. These changes are expanding treatment options and redefining long-term disease control for individuals once considered hard to treat.

Biologics Revolutionize Asthma Management

Biologic therapies have been central to this shift in asthma care. New drugs like dupilumab (Dupixent), benralizumab (Fasenra), and tezepelumab (Tezspire) have set new standards for effective intervention. The approval of tezepelumab in 2021, the first biologic for severe asthma not limited by eosinophil count, broadened treatment options. This progress is also strengthening collaboration between allergists and pulmonologists.

COPD management is starting to see similar innovation, with the 2024 FDA approval of dupilumab for eosinophilic COPD marking a significant step. As the lines between asthma and COPD continue to blur, clinicians need to reevaluate traditional treatment pathways.

Expert Insights on Emerging Therapies

A recent clinical forum brought together pulmonologists and allergists to discuss the updates in respiratory care, led by pulmonologist Joseph Khabbaza, MD, of Cleveland Clinic. Panelists discussed the central role of biologics in modern asthma management, particularly for those with type 2 inflammation. The use of biomarkers like eosinophils and FeNO has also grown substantially.

“I’ve been more aggressive with, if my patient needs steroids more than twice in 6 months or so, I’m pulling the trigger faster and faster, even without long-acting muscarinic antagonist (LAMA), just because I first-hand know the major long-term side effects of steroids 10 years, 15 years down the road,”

—Forum Participant

Another shift is that pulmonologists are managing biologics more often, and initiating them earlier to reduce steroid use and prevent long-term problems, despite payer criteria. The global prevalence of COPD is estimated to be around 10% of adults aged 40 years and over, highlighting the scale of the issue (World Health Organization, 2024).

Future Directions in Respiratory Care

COPD management is beginning to adopt similar principles, recognizing that some patients with type 2 inflammation may benefit from biologics. Panelists emphasized the need for longer-acting biologics, better phenotyping, and broader eligibility definitions, especially for COPD patients.

“Asthma and COPD have evolved over the last few years and with a lot of thinking about eosinophils and type 2 inflammation, and we now have more pathways and more treatments than ever before to try to help these patients. And we want to minimize prednisone, and minimize exacerbation. I think those are- If we can do those two things in asthma and COPD patients, that’ll be good for everyone in the system,” Khabbaza concluded.