Patient Introduction

Hello, my name is Richard and I'm 53 years old. I used to be a fairly heavy smoker but quit 8 years ago after I began experiencing recurring episodes of coughing, occasional shortness of breath, and even chest tightness. My internist diagnosed me with early COPD and referred me to a pulmonologist, and his diagnosis was confirmed. I was told that COPD is more commonly seen in somewhat older patients but can certainly occur in patients my age or even younger. My symptoms remained relatively unchanged until recently. I'm now experiencing more frequent episodes and have to use rescue medication more frequently. I'm familiar with COPD because my father was a smoker and had it for many years. I never should have started smoking cigarettes.

Question #1

In addition to more frequent COPD flares, have your symptoms gotten any worse or have you developed any new symptoms recently?

Answer

Question #2

That certainly is more frequent and severe than your previous flares. How have these symptoms affected your daily life generally?

Answer

Question #3

It sounds like these flares are taking a toll on you physically, but also on your quality of life. Does your current medication help control your COPD symptoms?

Answer

Question #4

I'm also concerned for COPD progression; your recent pulmonary function test showed a reduced resting lung volume. Have you stayed away from smoking?

Answer

Question #5

I ordered some other tests to get a better understanding of your changing symptoms. But I saw you didn’t complete the CT scan of the chest. Why did you cancel your appointment?

Answer

Question #6

Yes, you're describing type 2 inflammation, which has increased circulating eosinophils and accelerated worsening of airflow limitation, called FEV1 in some patients with COPD. This can serve as a possible treatment target in COPD; have you heard of monoclonal antibodies?

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Question #7

Yes, in some ways. Monoclonal antibodies are injectable drugs that, can suppress type 2 inflammation. Research has shown there may be a benefit to limiting this type of inflammation in COPD, especially with more frequent flare-ups, which you are experiencing.

Answer

Question #8

You would still need your current regimen, but maybe at lower doses or less often for rescue medications over time. Studies have also shown reductions in COPD flares and symptoms, as well as and improved lung function.

Answer

Question #9

At this time just one – dupilumab. It was approved years ago for other conditions like asthma and eczema, which share the type 2 inflammatory pathway with COPD. With your worsening symptoms, would you consider a monoclonal antibody?

Answer

This activity is provided by Med Learning Group.
This program is supported by an independent educational grant from Regeneron Pharmaceuticals, Inc. and Sanofi.
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