RX Review: Monoclonal Antibodies for COPD Management - Episode 5
In this video, the fifth in a 6-part series, panelists discuss the factors that influence initiating biologics for COPD.
In this special report from HCPLive, Joseph Khabbaza, MD, moderates an expert discussion with Nikita Desai, MD, and Eric Costanzo, MD, on the impact of and recent developments with monoclonal antibodies in chronic obstructive pulmonary disease (COPD).
In this clip, Costanzo and Desai explore how they approach real-world patient profiles when considering monoclonal antibody therapy for COPD. Costanzo emphasizes initiating early conversations about biologics, ideally at the time of diagnosis, to establish shared decision-making and to prepare patients for advanced treatment if disease progression or exacerbations occur. He underscores that even a single severe exacerbation or repeated steroid use should trigger evaluation for systemic inflammation and potential biologic initiation, particularly in patients with elevated eosinophil counts.
Desai highlights the clinical challenge of patients who remain well-controlled between occasional, virus-triggered exacerbations. In such cases, convincing patients to adopt biologics despite infrequent flares and few daily symptoms can be difficult. Both physicians stress the importance of individualized education, early expectation-setting, and rapport building to guide patients through treatment escalation when necessary.
Additionally, Desai points to encouraging real-world data suggesting that biologic therapies may lead to durable symptom remission even after discontinuation, reinforcing their long-term value beyond immediate exacerbation prevention. Ultimately, the panelists advocate for proactive, personalized COPD management that integrates biologics earlier in the treatment continuum to mitigate exacerbations, reduce corticosteroid exposure, and improve patient outcomes.
Part 1: The Biologic Era in COPD: What Mepolizumab Approval Means for Exacerbation Control
Part 2: From Rescue to Routine: Early Use of Biologics in COPD
Part 3: Targeting Type 2 Inflammation: COPD Lessons from Asthma Biology
Part 4: Next-Gen COPD Trials: What Clinicians Need from Biologic Studies
Part 5: Identifying COPD Candidates for Biologics: What Clinicians Should Know
Part 6: EP. 6: Monoclonal Antibodies and the Future of Lung Preservation in COPD
Our Panelists:
Joseph Khabbaza, MD, is a pulmonary and critical care physician at the Cleveland Clinic and a director of the non-cystic fibrosis bronchiectasis program., who serves as the moderator for this panel discussion.
Nikita Desai, MD, is a pulmonary critical care physician at Cone Health in Greensboro, North Carolina. She is triple board certified in critical care medicine, internal medicine, and pulmonary medicine.
Eric Costanzo, MD, is a pulmonary critical care and neurocritical care physician and program director of the Pulmonary and Critical Care fellowship at Jersey Shore University Medical Center with Hackensack Meridian Health System and Shore Pulmonary Associates
Relevant disclosures for Khabbaza include Insmed, Regeneron, Sanofi, and Baxter Healthcare Corporation. Desai and Costanzo have no relevant disclosures to report.
