Advances in COPD Treatment: A New Chapter in a Long-Fought Battle
Chronic obstructive pulmonary disease (COPD) remains a major public health concern in the United States. In 2021 alone, the disease claimed more than 138,000 lives, making it the sixth leading cause of death overall and the fifth leading cause of death from disease.
Yet amid these sobering numbers, we’re beginning to see a shift.
Roughly 85% of COPD deaths occur in adults aged 65 and older, a population long considered at the highest risk for complications. In recent years, however, death rates in this group have shown signs of decline.
At Remington-Davis (RDI), this shift reflects what we’ve seen on the ground. With more than 100 COPD trials conducted—including a growing number that focus on endotype-driven care—we've had the privilege of partnering with sponsors and CROs to help bring a new generation of therapies to market.
As we observe COPD Awareness Month this November, we reflect on the advances in COPD treatment and the role that clinical research plays in delivering those options to the people who need them most.
Targeted Therapies: Biologics Use in Treating Chronic Obstructive Pulmonary Disease
Just a few years ago, biologic therapies for COPD were still largely theoretical. Today, they’re changing what treatments are available, especially for patients whose disease is driven by eosinophilic inflammation, a specific immune system response involving elevated levels of white blood cells.
Historically, these patients were treated with inhalers and corticosteroids, but with inconsistent results. Now, thanks to a growing understanding of inflammatory endotypes, researchers can better identify which patients are most likely to benefit from biologic drugs that directly modulate the immune system.
In 2024, the first biologic was approved for patients with inadequately controlled eosinophilic COPD. Then in May 2025, Mepolizumab (Nucala) received FDA approval, targeting interleukin-5 (IL-5) to reduce inflammation. Clinical research shows it can lower exacerbation rates by 21%, a remarkable leap forward for a disease once considered nearly impossible to modify.
Recent trials at RDI have focused on this exact population—patients with high eosinophils or elevated FeNO—supporting research that brings asthma-style precision to COPD care. These studies use advanced endpoints like CT-based mucus plug quantification and inflammatory biomarkers to track response, helping personalize treatment pathways.
Beyond Symptom Relief: The Role of Triple Inhalers in COPD Management
While biologics offer a major step forward for a specific subgroup of patients, inhaler-based therapy remains essential for millions of others living with COPD.
Recent years have seen a rise in triple combination inhalers, which combine a LABA, LAMA, and ICS into one device. Approved in 2020, Breztri Aerosphere joined Trelegy Ellipta as a leading triple inhaler, offering greater flexibility in dosing and, for some patients, improved results over dual therapies.
While making breathing easier, triple therapy inhalers may also offer cardiovascular benefits to COPD patients. Studies suggest they may reduce the risk of heart-related complications, an especially important finding given the overlap between COPD and cardiovascular disease.
At clinical trial sites like RDI, inhaler studies are increasingly focused on lung function and the total patient experience, evaluating dyspnea relief, fatigue reduction, and quality-of-life outcomes.
Preventing the Preventable: The Promise of Combination Vaccines
Another key area of progress in COPD care is prevention—specifically, reducing the risk of respiratory infections that can trigger COPD exacerbations and hospitalizations.
COPD patients are especially vulnerable to infections like influenza, RSV, pneumonia, and COVID-19. And yet, vaccination rates remain stubbornly low, in part because patients are reluctant to undergo multiple injections and appointments each year.
That’s why there’s growing momentum behind combination vaccines that protect against multiple viruses in a single dose. These next-generation vaccines could streamline care and dramatically improve adherence, especially among older adults or those with multiple comorbidities.
Sites like RDI have contributed to this work through vaccine trials that assess immune response, real-world compliance, and safety in high-risk populations. These studies are paving the way for a future where more people are protected and fewer are hospitalized for something that could be prevented.
Looking Inside the Lungs: Imaging and Mechanistic Insight
As our understanding of COPD deepens, so too does our ability to measure and monitor it.
Modern imaging technologies like high-resolution CT scans and impulse oscillometry now allow researchers to visualize structural changes—such as mucus plugging, air trapping, and airway remodeling—that spirometry alone can’t detect. These insights are helping design treatments that target the problem at its source to curb disease progression.
At RDI, these imaging tools are increasingly integrated into COPD trials, providing functional and structural endpoints that support biomarker-driven research. Recent studies include exploratory endpoints related to airway thickness, lung hyperinflation, and oscillometric airflow resistance.
A Breath of Progress: What’s Next for COPD Patient Care
The future of treating COPD is about identifying the right intervention for the right patient—based on biology, imaging, and real-world response.
COPD isn’t just “smoker’s lung.” It’s a multifaceted condition shaped by immune function, mucus dynamics, and airway remodeling. Some patients respond best to anti-inflammatory therapies, others to advanced bronchodilators, and still others may benefit most from early preventive interventions.
At Remington-Davis, we’ve spent over 30 years and conducted more than 100 COPD studies to help bring forward therapies that meet patients where they are. As the field continues to advance toward care that’s personalized, predictive, and preventive, we remain committed to research that makes each breath a little easier—and each day a little better—for those living with COPD.
Frequently Asked Questions About COPD & Clinical Trials
What is considered standard treatment for COPD?
The most common treatment for chronic obstructive pulmonary disease (COPD) is bronchodilator therapy. These medications relax the muscles around the airways, making it easier to breathe. They are usually taken through an inhaler and can be short-acting or long-acting, depending on the severity of persistent respiratory symptoms.
How is COPD classified in terms of severity?
COPD is often classified as mild, moderate, severe, or very severe, based on a combination of symptoms, lung function (measured by spirometry), and history of exacerbations. Patients with severe COPD typically experience frequent shortness of breath, limited activity levels, and an increased risk of hospitalizations due to flare-ups.
What are the main COPD risk factors?
The most common risk factor for COPD is long-term exposure to tobacco smoke, including secondhand smoke. Other contributing risk factors include long-term exposure to air pollution, chemical fumes, or workplace dust; a history of frequent respiratory infections; and genetic conditions such as alpha-1 antitrypsin deficiency, which can make the lungs more vulnerable to damage.
What role does pulmonary rehabilitation play in COPD care?
Pulmonary rehabilitation is a structured program that combines supervised exercise, breathing techniques, nutritional counseling, and disease education to improve quality of life for people with chronic obstructive lung disease. It’s especially beneficial for patients with moderate to severe disease or those recovering from recent flare-ups.
Some clinical studies include pulmonary rehab as part of the treatment protocol or study how rehab impacts exacerbation frequency, exercise tolerance, or patient-reported outcomes.
Why is chronic bronchitis a key inclusion focus in COPD clinical trials?
Many COPD clinical trials are now stratifying by phenotype—including patients with chronic bronchitis, who represent a distinct and often underserved subgroup. This population typically experiences persistent cough and mucus hypersecretion and may respond differently to anti-inflammatory or mucolytic therapies than patients with emphysema-dominant chronic respiratory diseases.