RX Review: Monoclonal Antibodies for COPD Management - Episode 3
In this video, the third in a 6-part series, panelists discuss how learnings from asthma management are informing COPD management.
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 discuss the evolving understanding of type 2 inflammation in COPD and how this growing insight is reshaping treatment strategies. Once considered exclusive to asthma, type 2 inflammation is now recognized in up to 40% of COPD patients—a realization that is informing both diagnostic evaluation and therapeutic decision-making.
Costanzo emphasizes how academic programs have long recognized eosinophilic inflammation as a potential COPD phenotype, and now that phase 3 data supports targeted therapy, this concept is becoming part of standard care pathways. He describes how biologics are being introduced early in post-discharge treatment plans, incorporated into education for trainees, and discussed with patients as part of personalized COPD care.
Desai stresses the need to reframe clinician and patient perspectives around biologics, especially in contrast to systemic corticosteroids. While biologics are often perceived as "high-risk," short courses of prednisone carry well-documented long-term harms—including cardiovascular and metabolic risks—that patients often underestimate. Both experts agree that early biologic use can not only reduce exacerbation frequency but also prevent hospitalizations, where outdated high-dose steroid protocols still prevail.
The panelists theorize that future biologic development may expand beyond IL-4, IL-5, and IL-13 to target additional cytokines involved in type 2 inflammation, offering even more precise and steroid-sparing options for COPD patients.
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.
