Dr. Ahmed Chronic Obstructive Pulmonary Disease (COPD) is a long-term lung disease that makes breathing difficult, which often turns simple tasks like walking or talking into a challenge.
In the past, treatment mainly aimed to ease symptoms and stop flare-ups. But now, COPD care is changing fast, which brings fresh hope and better living for patients.
With new drugs and advanced medical procedures, these modern treatments are reshaping how COPD is managed.
The current and crucial therapies
Before we read about the latest breakthroughs, it is important to acknowledge the cornerstones of COPD management that remain essential for every patient:
- Quitting smoking is, without question, the most powerful thing someone with COPD can do to slow the disease and feel better long term. There are many support programs and resources available to help.
- Bronchodilators, which are usually taken through inhalers, help open the airways by relaxing the surrounding muscles, making it easier to breathe. Some give fast relief, while others work long-term for daily use.
- Inhaled corticosteroids (ICS), often used with bronchodilators, help calm airway inflammation and are especially useful for people who often have flare-ups.
- Pulmonary rehabilitation is a full program with exercise, education, diet help, and emotional support to help people take control of their health and feel stronger.
- Supplemental oxygen therapy is helpful for people with low blood oxygen levels and can boost energy, organ health, and daily activity.
- Yearly flu shots and pneumonia vaccines are vital for people with COPD to avoid infections that could make their condition worse.
New Treatment Options for COPD | Emerging Medications and Biologics
The most exciting recent advancements lie in novel pharmacological agents and targeted therapies:
Triple therapy inhalers:
These combination inhalers contain three types of medicines: a steroid to reduce swelling, a drug to relax the muscles in the airways (LAMA), and another that helps keep the airways open (LABA).
Popular brands like Breztri Aerosphere and Trelegy Ellipta make treatment easier and work better than inhalers with just two medicines. They help improve breathing and reduce flare-ups in people with lung problems.
Ensifentrine:
Ensifentrine is a new and unique treatment that works in two ways, as a bronchodilator and an anti-inflammatory.
It was approved by the FDA in June 2024 and is taken through a nebulizer. Studies have shown it helps people with stable COPD by improving their breathing and reducing flare-ups, with few side effects.
Biologic therapies (targeting type 2 inflammation):
A significant paradigm shift in COPD treatment is the advent of biologics for patients with a specific inflammatory subtype, often characterized by elevated eosinophil counts.
- Dupilumab (Dupixent):
Dupilumab was approved in September 2024 as the first biologic medicine designed specifically for COPD caused by type 2 inflammation. It works by blocking IL-4 and IL-13, two key pathways behind this type of inflammation. [ref]
- Mepolizumab (Nucala):
The FDA approved Mepolizumab (brand name Nucala) in May 2025 for COPD. It targets IL-5 and offers another option for treating eosinophilic COPD, especially for patients who haven’t improved with standard treatments. These biologics focus on reducing inflammation and flare-ups in certain COPD patients.
- Roflumilast (Daxas/Daliresp):
Roflumilast (also known as Daxas or Daliresp) is a pill used for people with severe COPD, especially those with chronic bronchitis and frequent flare-ups. It lowers lung inflammation and is usually given as an extra treatment alongside other medications.
Advanced Interventional Procedures
For patients with severe emphysema, a component of COPD where air sacs are damaged and over-inflated, non-surgical and surgical interventions offer further relief:
Endobronchial Valve (EBV) therapy:
In this less invasive treatment, small one-way valves are placed in the most damaged parts of the lungs.
These valves let trapped air out, helping reduce pressure and making it easier for the healthier parts of the lung to work better. This can improve breathing and help patients be more active.
Lung Volume Reduction Surgery (LVRS):
This surgery is for certain people with serious lung damage, mainly in the upper parts of their lungs. The surgeon removes the most damaged parts to reduce pressure and help the rest of the lung work more efficiently.
Bullectomy:
In this surgery, large air pockets (called bullae) are removed from the lungs. These bullae can press on healthy lung tissue and make breathing harder. Taking them out can improve lung function.
Lung transplantation:
This is a major surgery where one or both lungs are replaced. It is considered only for a small number of people with very severe COPD who have not improved with any other treatment.
What’s Next in COPD Research?
The future of COPD treatment is bright, with ongoing research exploring:
New Dual PDE Inhibitors:
Besides ensifentrine, several new medicines that block two PDE enzymes at once are being tested. They aim to open up the airways better and reduce inflammation, all while keeping side effects low.
Targeted Lung Denervation (TLD):
This is a procedure done with a scope inside the lungs. It tries to block certain nerves that cause the airways to tighten and produce too much mucus. Early studies suggest it may help reduce breathing problems. [ref]
Bronchial rheoplasty:
This treatment also uses a scope and sends mild electric pulses to destroy cells that make too much mucus. It may help people with chronic bronchitis breathe easier.
Anti-oxidative agents:
Researchers are working on drugs that fight oxidative stress, one of the causes of COPD damage. These drugs could possibly slow down or change how the disease develops.
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