What Carents Should Know About Dupilumab

Medically Reviewed by: Dr Jackie Gray, Public Health Expert and Retired GP
(Carents Trusted Reviewer Programme – Last reviewed March 2026)

Dupilumab, also known by the brand name Dupixent, is a treatment designed for people with severe COPD who have higher levels of a type of white blood cell called eosinophils.

Around 40 percent of people with COPD have this type of inflammation, sometimes called eosinophilic COPD.

Dupilumab works by blocking two proteins in the immune system that drive inflammation in the lungs. By calming this inflammation, it can reduce flare-ups and improve breathing stability.

It is the first new biologic treatment for COPD approved on the NHS in several years.

Eosinophilic COPD is a type of COPD linked to higher levels of eosinophils, a type of white blood cell involved in inflammation. Not everyone with COPD has this. That is why blood testing matters.

If you are caring for someone with severe COPD and frequent flare-ups, it is worth asking whether eosinophil levels have been checked. This is usually a simple blood test. It does not require anything complicated or invasive.

Why does this matter? Because Dupilumab is only offered on the NHS to people whose COPD is linked to this type of inflammation. Without raised eosinophils, it is unlikely to be effective and will therefore not be approved.

Many carents assume that if someone has severe COPD and repeated flare-ups, all treatment options have already been explored. That is not always true. Blood markers can guide treatment decisions.

If testing has not been done recently, you can ask whether it should be repeated. Results can change over time, especially if steroid use has been frequent.

Clinical studies show that Dupilumab can:

• Reduce COPD flare-ups by around one third
• Improve lung function
• Reduce the need for repeated courses of steroid tablets
• Improve quality of life
• Start showing benefits within two weeks
  
  

If you are caring for someone with frequent COPD flare-ups, this could mean:

• Fewer emergency GP appointments
• Fewer hospital admissions
• Less reliance on repeated steroid courses
• Less anxiety during colder months
• More predictable day-to-day life
  
  

It does not remove COPD. But it may reduce the constant crisis and recovery pattern that many carents live with.

If you are dealing with frequent COPD flare-ups, it can be hard to know what counts as “normal” for severe disease and what suggests treatment needs reviewing.

Signs it may be time to ask about new treatment for severe COPD include:

• Two or more flare-ups in a year requiring steroids or antibiotics
• One or more hospital admissions
• Breathlessness worsening despite correct inhaler use
• Recovery taking longer each time
  
  

Many carents adapt gradually and what once felt like a crisis becomes routine - but repeated flare-ups increase long-term lung damage and strain on the body.

If you find yourself collecting repeat prescriptions for steroid tablets every few months, that is worth raising. Long-term or repeated steroid use has side effects, including mood changes, sleep problems, bone thinning and increased infection risk.

Asking about Dupilumab for COPD on the NHS is not about chasing the latest drug, it’s about reducing the pattern of crisis that could be wearing you and your loved one down.

Dupilumab is:

• Given as a self-injection every two weeks
• Supplied in a pre-filled injection pen
• Designed to be used at home
  
  

Healthcare teams provide training on how to use it safely. Regular check-ups are needed to monitor how well it is working.

For some carents, helping with injections may feel daunting at first. Training and support are part of the process.

Not everyone with COPD will qualify.

It is currently intended for people who:

• Have severe COPD
• Continue to have frequent flare-ups despite using all standard inhalers
• Have raised eosinophil levels on blood testing
  
  

A GP, respiratory nurse or hospital consultant will assess whether someone meets the NHS criteria.

If you are unsure whether eosinophil testing has been done, you can ask. It is a standard blood test.

If the person you support is:

• Frequently experiencing flare-ups
• Needing repeated steroid courses
• Still struggling despite strong inhaler treatment
  
  

It is reasonable to ask their GP or respiratory consultant whether Dupilumab is available for them on the NHS.

You might ask:

• Has eosinophil testing been done?
• Do they meet the NHS criteria for Dupilumab?
• Could this help reduce flare-ups?
• What would the assessment process involve?
  
  

COPD flare-ups can be frightening. Breathlessness can escalate quickly and nights can be long. You may find yourself listening for changes in breathing or deciding whether it is time to call for help.

Repeated steroid courses also take a toll, physically and emotionally.

Dupilumab will not work for everyone. Some people will not meet the criteria. That can be disappointing.

But for those who do qualify, this new NHS treatment for severe COPD could mean:

• More stable breathing
• Fewer emergencies
• Fewer hospital stays
• A bit more breathing space for everyone in the house
  
  

When you are caring for someone with severe COPD, even small reductions in crisis can make a real difference.

You can encourage your loved ones to seek help by helping them understand what different treatments involve and also what the benefits might be.

In most instances, a health professional – usually a GP or hospital specialist – will need to refer someone with COPD for physiotherapy or pulmonary rehabilitation.

Pulmonary rehabilitation is a relatively new service in some parts of the country, and so it might not be routinely offered to every patient.  Given its benefits, it is well worth encouraging your parent to discuss with their GP, practice nurse or hospital specialist whether pulmonary rehabilitation could help them. Age should never be a barrier.

Medically reviewed by Dr Jackie Gray, July 2025