RX Review: Monoclonal Antibodies for COPD Management - Episode 4
In this video, the fourth in a 6-part series, panelists discuss how future studies of monoclonal antibodies in COPD could be refined.
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 reflect on the limitations of current clinical trial designs evaluating monoclonal antibodies in COPD, particularly in light of the MATINEE study. Dr. Desai notes that MATINEE was conducted during the COVID-19 pandemic, a period of widespread masking, social distancing, and reduced viral exposure, factors that may have suppressed exacerbation rates and complicated generalizability to post-pandemic populations.
Both clinicians agree that future studies should extend follow-up duration and place greater emphasis on patient-reported outcomes, especially symptom burden and quality of life. While biologics have demonstrated efficacy in reducing exacerbation frequency and delaying time to first exacerbation, daily symptom relief is not guaranteed—a disconnect that underscores the importance of managing patient expectations around treatment goals. Desai emphasizes that improvements in time to exacerbation and corticosteroid reduction are clinically meaningful, but may not align with what patients value most.
Costanzo advocates for the inclusion of objective functional endpoints, such as 6-minute walk tests and exercise tolerance, to capture subtle improvements that may not be fully perceived by patients. Both experts agree that refining endpoints and extending trial duration will be essential to advancing the role of biologics in COPD care.
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.
