IN SEARCH OF NOVEL PHARMACOLOGICAL THERAPIES FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) remains a significant global health challenge. Its progressive nature and variability in symptoms—often resulting in exacerbations and hospitalizations—contribute to a lower quality of life, reduced physical activity, and impaired psychological well-being. Despite advances in treatment, tailored to symptom severity, disease progression continues to be a major challenge. Current pharmacological therapeutic strategies primarily involve bronchodilators and inhaled corticosteroids. However, there is a persistent need for more effective and targeted interventions. Methods: A comprehensive literature review was conducted for English-language publications using databases such as PubMed. Meta-analyses, systematic literature reviews, randomised controlled trials, cohort studies, case-control studies and cross-sectional studies were included. Articles published after 2016 were reviewed; in the case of older articles, only those that made a significant new contribution to the field were taken into consideration. Methodological rigor and limitations of included studies were critically discussed. Results: Several therapies have demonstrated clinically relevant effects in late-stage trials, leading to recent regulatory approvals in the United States: ensifentrine in 2024 as a dual PDE3/PDE4 inhibitor for maintenance treatment of COPD, dupilumab in 2024 as maintenance biologic therapy for COPD with an eosinophilic phenotype, and mepolizumab in 2025 as maintenance treatment for inadequately controlled eosinophilic COPD. Other investigational agents, including IL-33 pathway inhibitors such as itepekimab and tozorakimab, have produced mixed or emerging Phase III results. Conclusions: This review examines recent advancements in COPD therapy, with an emphasis on ongoing research and emerging pharmacological candidates that hold promise for improving patient outcomes.