best peptide for copd FAQ

Although we give this condition the umbrella term of COPD, there are different types, or subcategories. Mepolizumab's label specifies that this treatment is for people with the eosinophilic phenotype of COPD. This represents about 20% to 40% of all people with COPD. These are the specific people for whom mepolizumab has demonstrated a benefit.

Mepolizumab was approved based on its ability to decrease exacerbations in patients with an eosinophilic phenotype of COPD. In clinical trials, people on mepolizumab had a reduction in flare-ups of 30% to 35%. I always tell my patients that our ultimate goal for exacerbations is zero. But there is still value in reducing them by 30% to 35%. Each exacerbation has the potential to put you in the hospital, and these visits can increase mortality. So anything we can do to reduce exacerbations at all is helpful. It is possible for some people not to respond to anything. That's the unfortunate reality of a progressive chronic disease. But also, if you haven't responded to one biologic therapy, it doesn't mean that you won't respond to a different one.

Up until 30 years ago, virtually all the therapies that came on the market for COPD were small molecule drugs [those with molecules small enough to easily cross cell membranes]. They were often derivatives of naturally developed products. Then, scientists started introducing biologic drugs as a different type of treatment for COPD. Biologics were developed as therapy that takes advantage of the way our immune system creates antibodies to certain bacteria and other products. Biologics are targeted therapies that focus on a very specific pathway. In September 2024, the FDA approved the first biologic – dupilumab (Dupixent) – for the treatment of COPD. Now we have a second biologic treatment option, mepolizumab. Dupilumab and mepolizumab target different inflammatory pathways in the body. Dupilumab targets and blocks proteins called interleukin 4 (IL-4) and interleukin 13 (IL-13). Mepolizumab targets interleukin 5 (IL-5), which is a part of the immune system that is activated in allergic reactions.

As with most drugs, there are warnings related to pregnancy and breastfeeding. That's not typically an issue in the COPD population, but there's always that potential. The drug also targets the same part of the immune system that helps fight parasitic infections, so you'll need to take that into consideration if you're taking mepolizumab in parts of the world where that's a concern. Also, if you're on oral or inhaled steroid medications, you shouldn't stop those while taking mepolizumab without the guidance of your doctor. If it looks like treatment is working, there may be an opportunity to decrease the systemic corticosteroids.

You take mepolizumab as an injection under the skin once a month. Your doctor will give you the first injection in the office. After that, you can give them to yourself at home with a self-injecting formulation.

Biologic therapies are more expensive than other therapies we have out there, and typically too expensive for people to afford out of pocket. Because insurance companies are the ones that pay for the bulk of these therapies, they tend to withhold coverage unless someone has tried less expensive therapies first. At the University of Kentucky, we have a pharmacist in our clinic whose main job is to help people gain access to these therapies. They work to demonstrate what therapies someone is currently on, how they are not working for them, why they would benefit from the therapy, and to be sure that they meet the various criteria that insurers have set.

The most common side effect is a reaction at the site of your injection. Some people get a sore arm related to that. But there can be more serious side effects in people who have a hypersensitivity or allergic reaction to the injection itself. That serious injection site reaction is very rare, but it's typically why the first injection happens under the supervision of a doctor – so they can watch for symptoms like swelling of the mouth, breathing issues, feeling lightheaded, or hives. If you don't have these symptoms after the first injection, you can give yourself the rest of the injections at home.