If you or someone close to you suffers from chronic shortness of breath, persistent cough, and reduced physical fitness, there is a chance it may be COPD. This is a serious lung disease affecting millions worldwide, and until recently, treatment options were limited. However, at a recent international medical conference, particularly encouraging findings were presented: An innovative biologic treatment that significantly reduces the dangerous flares of the disease.
COPD (Chronic Obstructive Pulmonary Disease) is a chronic obstructive lung disease, currently considered one of the most significant and deadly chronic conditions in the Western world. The disease is most often caused by prolonged exposure to cigarette smoke, but air pollution, exposure to harmful particles at work, and genetic predisposition can also be risk factors.
In this disease, the airways and lungs are gradually and irreversibly damaged: They become flooded with mucus, stiffen, and are obstructed, leading to severe breathing difficulties, chronic cough, dramatic declines in physical fitness and quality of life, and in severe cases—even death.
According to the World Health Organization, COPD is one of the leading causes of death worldwide, and this trend is expected to worsen in the coming years as the smoking population ages.
Flares: The Biggest Enemy of COPD Patients
Beyond the slow and continuous progression of the disease, there is another immediate and dangerous risk: Flare-ups—acute events in which symptoms dramatically worsen within days or even hours. The patient suddenly finds it harder to breathe than usual, the cough intensifies, mucus production increases, and sometimes fever appears.
Each flare is not just a single event—it can lead to urgent hospitalization, permanently worsen lung tissue damage, and accelerate disease progression. Patients who experience repeated flares have shorter lifespans and significantly reduced quality of life.
The Surprising Discovery: Not All COPD Patients Are the Same
At the recent ERS (European Respiratory Society) conference, attended by leading international experts, one of the burning topics in pulmonary medicine was discussed—the management of COPD and its flares.
During a dedicated symposium, an important finding was highlighted: Approximately 40% of COPD patients suffer from a specific type of lung inflammation called “Type 2 inflammation.” This patient population is characterized by overactivity of certain immune system cells (eosinophils).
The numbers speak for themselves:
- The rate of flares in this group is 74% higher compared to other COPD patients
- The risk of hospitalization is 64% higher
- The impact on quality of life is highly significant
The positive point is that this population may benefit the most from advanced biologic treatments—if they are identified in time.
The Problem: Many Patients Are Not Properly Diagnosed
Although the test to identify Type 2 inflammation is very simple—a routine blood count measuring eosinophil levels—many patients are not correctly diagnosed in practice.
A global survey presented at the conference revealed worrying findings:
- About 40% of doctors do not perform the test regularly
- About 10% do not perform it at all
- About 30% perform it only once, at the initial diagnosis
The problem is that a one-time test is not sufficient. Eosinophil levels change over time, so periodic monitoring is needed to identify all relevant patients. This missed diagnosis leads to lost opportunities for a treatment that could alter the disease course.
The Good News: A Biologic Treatment That Proves Effective
At the heart of the symposium, results of the MATINEE study were presented—a clinical trial examining the effectiveness of a new biologic treatment called Nucala (generic name: Mepolizumab). This is a monoclonal antibody targeting a protein called IL-5, involved in Type 2 inflammation.
The study focused on COPD patients with recurrent flares and Type 2 inflammation who had already received maximal standard inhaled therapy (known as “triple therapy”).
The results were clear and significant: The biologic treatment reduced moderate and severe flare rates by 21% compared to placebo.
This is a particularly meaningful achievement for patients whose treatment options were previously limited and had exhausted all existing possibilities. Any reduction in flares means fewer hospitalizations, less suffering, better preservation of lung function, and improved quality of life.
This treatment joins another biologic—Dupixent (Dupilumab)—which has already proven effective in reducing flares in COPD patients with Type 2 inflammation.
Not Everything Works: Understanding Successes and Failures
It is important to note that not all attempts to reduce flares have succeeded. The symposium presented five additional studies on three different molecules, all of which ended with negative results—meaning they did not show a significant reduction in flare frequency.
Given the high burden of disease, mortality, and economic cost of COPD flares, many studies are currently underway in advanced stages (Phase 2 and 3) on various molecules. The success of the MATINEE study with Nucala stands out against other failures and emphasizes the importance of finding the right treatment for the right patient population.
COPD flares are not only a personal medical problem. They are also a major economic and social challenge. Each flare involves repeated hospitalizations, prolonged sick days, dramatic declines in function, and a heavy burden on healthcare systems and patients’ families. Therefore, any advancement in treatment—especially one that prevents flares—can be a game-changer.
The Key Conclusion from the Conference: The Future Lies in a Proactive Approach
- Early identification of patients with Type 2 inflammation through periodic blood tests
- Continuous monitoring of eosinophil levels over time
- Personalized biologic treatment for appropriate patients
Through this approach, we can reduce life-threatening events, significantly improve patients’ quality of life, reduce hospitalizations, and even extend their lifespan.
A New Hope for a Long-Suffering Population
The data presented at the conference represents a significant milestone in the journey to improve treatment for COPD patients. While there is still a long way to go and research continues, the new biologic drugs mark a new and optimistic era.
For the first time, it is possible to provide an effective, tailored response to a wide population of patients who have needed it for many years—provided they are correctly identified and treated in time.
The important message for patients and their families: If you are being treated for COPD and still experience repeated flares despite therapy, it is worth discussing with your doctor the possibility of a blood test for eosinophils to see if you are eligible for the new biologic treatments. Proper identification can significantly improve your quality of life.
Dr. Amir Bar-Shai, Pulmonology Specialist, Director of the Pulmonology Institute at Ichilov