New hope for people with breathing condition, COPD, as NICE approves innovative treatment

Breakthrough therapy reduces flare-ups by almost a third and could ease pressure on NHS hospitals 

Almost 30,000 people in England with a respiratory disease called COPD (chronic obstructive pulmonary disease) could have their lives transformed after NICE today recommended a new targeted treatment that can be taken at home. 

Dupilumab, a simple pre-filled pen that people inject themselves with every two weeks, is the first biologic that targets both the symptoms of COPD and an underlying cause of the disease. It brings the disease under better control, helping to reduce flare-ups, improve breathing and offers new hope to patients with limited treatment options. 

In clinical trials, the drug reduced COPD flare-ups by around 30%. Participants also reported significant improvements in lung function and were able to breathe more easily.  

Up to 4 in 10 people with COPD have a specific type of COPD inflammation shown by raised levels of certain white blood cells (eosinophils). Dupilumab is the first treatment to target this type of COPD and works by blocking two proteins that cause symptoms and flare-ups. 

COPD flare-ups can be devastating, often requiring admission to hospital and steroid treatments that can have serious side effects. Patient experts told NICE that flare-ups typically last one to two weeks and can be extremely debilitating, affecting people's ability to work and carry out daily activities. 

COPD causes around 130,000 emergency NHS hospital admissions each year in England. By significantly reducing flare-ups, dupilumab could help ease pressure on hospitals while reducing the need for steroid prescriptions. If half the eligible population receive this new treatment, there could be around 3,600 fewer COPD attacks, saving the health service an estimated £16.5m. 

Helen Knight, NICE Director of medicines evaluation, said: 

“This recommendation is a significant milestone for people with COPD. It offers patients an effective, targeted therapy that has shown impressive results - reducing flare-ups by around a third while improving lung function. This is better for patients and better for the NHS. 

“For people whose COPD remains uncontrolled despite existing treatments, dupilumab offers genuine hope for a better quality of life. Recommending this medicine demonstrates NICE is continuing to get the best care to patients while ensuring value for the taxpayer.” 

Sarah Sleet, Chief Executive of Asthma + Lung UK, said:  

“This is the first ever targeted treatment for people with uncontrolled COPD and a major milestone for those who could soon be able to access it. While not everyone will be eligible for this drug, this is the most important breakthrough in COPD care in nearly a decade. COPD can have a life-limiting impact on people's lives, leaving people struggling with daily tasks as they fight to breathe. 

“Today's announcement will bring hope to many who have not been able to access treatment that could transform their lives. Now we need to improve wider COPD care and, subject to final guidance, ensure that everyone who could be helped by dupilumab is able to access it”. 

Dr Jonathan Fuld, National Clinical Director for respiratory disease at NHS England, said: “Many people with COPD live under the constant worry of when their next disease flare up could lead to an episode of disabling breathlessness or an emergency hospital admission. 

“The NHS rollout of a take-at-home jab for COPD will transform the lives of around 100,000 people over the next few years, cutting the chances of them having severe exacerbations by one-third for the first time as well as improving their quality of life. 

“People taking the injection in trials saw improvements within a fortnight, and with the NHS seeing more than 120,000 emergency admissions for COPD each year, this new medication could also soon help to ease pressure on A&E departments.” 

COPD is a chronic, progressive lung condition that causes a person's airways to become obstructed, making it hard to breathe. Common symptoms include shortness of breath, chronic cough and chest tightness. It is characterised by episodic flare-ups known as exacerbations. The more severe forms of the disease are a major risk factor for developing heart failure. There are an estimated 1.2 million people with a COPD diagnosis in the UK. 

Dupilumab is recommended for adults with uncontrolled COPD who have raised blood eosinophil levels and have experienced at least one severe flare-up, or two or more moderate flare-ups, in the previous 12 months, despite being on maximum inhaler therapy. 

NHS England has negotiated an innovative commercial deal with French pharmaceutical company, Sanofi, enabling the rollout of the treatment dupilumab in this indication. 

Read the full guidance for dupilumab for maintenance treatment of COPD with raised blood eosinophils. 

Notes to editors 

- Dupilumab, also known as Dupixent and made by Sanofi, is recommended as an add-on maintenance treatment for adults with uncontrolled COPD who have a raised blood eosinophil count and are already receiving triple or double therapy. Patients must have experienced either one or more severe exacerbations, or two or more moderate exacerbations, in the previous 12 months. 

- The guidance also states Healthcare professionals should assess the patient's response to dupilumab at 12 months. Stop dupilumab if, compared with the 12 months before starting it, the number of severe exacerbations:  

• is higher, or  

• is the same, and the number of moderate exacerbations is higher.