Overview
- NICE’s final draft guidance recommends dupilumab as an add-on maintenance option for adults with uncontrolled COPD marked by raised blood eosinophils, making it the first targeted biologic for this group.
- Approximately 30,000 people in England may qualify based on criteria that include eosinophils of at least 300 cells/µL and recent exacerbations despite optimal inhaler therapy.
- Pooled phase 3 BOREAS and NOTUS data showed about a 31% reduction in annualised moderate or severe exacerbations versus placebo, with early and sustained improvements in lung function and quality of life.
- NHS England must fund access within 90 days of the final guidance, with a confidential commercial arrangement in place and mandated 12‑month response assessments that require stopping treatment if exacerbations do not improve.
- NICE modelling suggests that treating half of those eligible could prevent roughly 3,600 exacerbations each year and save the health system about £16.5 million.