Efficacy and Safety of Dupilumab in Chronic Obstructive Pulmonary Disease with Type 2 Inflammation: A Single-Center Real-World Study.

PURPOSE: To evaluate the efficacy and safety of dupilumab combined with triple inhaled therapy in patients with chronic obstructive pulmonary disease (COPD) with type 2 inflammation in a real-world setting.

PATIENTS AND

METHODS

This retrospective cohort study included patients with COPD and a type 2 inflammatory phenotype treated at the First Affiliated Hospital of Soochow University between October 2024 and December 2025. Propensity score matching (1:1) was performed to generate a study group receiving dupilumab plus triple therapy (ICS/LABA/LAMA) (n = 34) and a control group receiving triple therapy alone (n = 34). Pulmonary function, symptom scores, inflammatory biomarkers, acute exacerbations, and adverse events were assessed over 24 weeks.

RESULTS

After 24 weeks, improvements in pulmonary function, symptom burden, and airway inflammation were observed in patients receiving dupilumab combined with triple therapy. In the dupilumab group, FEV1 increased by 0.20 L, CAT score decreased by 3.70 points, and FeNO levels decreased by 8 ppb. Compared with the control group, greater associated improvements were observed in FEV1 (adjusted between-group difference: 0.12 L) and FEV1% predicted, along with greater reductions in CAT score, mMRC score, and FeNO levels (all P < 0.05). The annualized exacerbation rate was lower in the study group than in the control group (0.49 vs. 1.21 events per person-year), with regression analyses showing results approaching statistical significance (P = 0.058). Adverse events were mainly mild injection-site reactions and did not affect treatment continuation.

CONCLUSION

Dupilumab combined with triple inhaled therapy was associated with improvements in lung function, symptom burden, and airway inflammation in COPD patients with type 2 inflammation, with a favorable safety profile. A potential reduction in exacerbation risk was also observed, although further prospective studies are needed for confirmation.