Biologics for eosinophilic COPD: current applications and future prospects

Chronic obstructive pulmonary disease (COPD) is a heterogeneous pulmonary disorder characterized by persistent airflow limitation and symptoms of progressive dyspnea, cough, and sputum. While traditionally linked to type 1 immunity, a significant subset of patients presents with eosinophil-predominant type 2 inflammation. These individuals remain at risk of exacerbations despite receiving triple therapy, underscoring the need for novel biologics targeting type 2 pathways. Monoclonal antibodies against targets such as IL-5/IL-5Rα, IL-4, IL-13, IL-33/ST-2, and thymic stromal lymphopoietin (TSLP) have shown considerable promise. Therefore, the identification of accurate and accessible biomarkers for type 2 inflammation is crucial. This review summarizes the current applications and future prospects of emerging biologics in eosinophilic COPD, with a specific focus on the role of biomarkers.