Bhatt 2023 — BOREAS dupilumab

One-paragraph summary

BOREAS randomized patients with COPD, chronic bronchitis, blood eosinophils at least 300/µL and exacerbations despite triple therapy to dupilumab or placebo. Dupilumab reduced annualized moderate/severe exacerbations and improved FEV1 and health status, providing phase 3 proof for a type-2-targeted COPD endotype (PMID 37272521).

Key findings

• Biomarker and phenotype enrichment produced clinically coherent benefit.
• A later phase 3 trial replicated the central result (PMID 38767614).

Limitations

• Excludes broad COPD and asthma; threshold generalization is unknown.
• Long-term comparative sequencing with ICS is unresolved.

Why it matters

It is the first decisive precision-biologic result in COPD.

Cited by wiki pages

• Overview
• Inflammation and endotypes
• Clinical trials landscape