RX Review: Monoclonal Antibodies for COPD Management - Episode 6
In this video, the last in a 6-part series, panelists discuss the potential future impact of biologics in the COPD field.
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, Desai and Costanzo reflected on the future direction of monoclonal antibody use in COPD, including sequencing, combination therapy, and long-term impact on disease progression. Desai highlighted that, while current use is largely shaped by payer approvals and clinical trial inclusion criteria, she typically assesses efficacy after 6 to 12 months before switching agents, acknowledging the need for head-to-head trials to inform sequencing decisions. Simultaneous biologic therapy, while mechanistically plausible, remains unlikely in the near future due to cost and logistical barriers.
Turning to disease modification, Costanzo emphasized the importance of early, upstream intervention to limit inflammatory cascades that drive irreversible lung remodeling. He underscored the clinical value of preserving lung function, noting that while COPD cannot be cured, biologics may arrest progression and mitigate long-term damage. Both clinicians agreed that unchecked type 2 or neutrophilic inflammation leads to structural changes and that the evolving use of targeted therapies offers an opportunity to protect lung health over time. As the field advances, they anticipate growing physiologic and imaging data will reinforce biologics’ role in modifying COPD's natural history.
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.
