Singh Advocates for Anti-Alarmin Therapy to Target COPD Inflammation

Biologic therapies face biological hurdles in COPD

Clinical trials for asthma biologics have met with mixed results when applied to patients with Chronic Obstructive Pulmonary Disease (COPD), HCPLive reported.

While these advanced treatments have transformed asthma care, their effectiveness in COPD patients has been inconsistent. This discrepancy highlights a fundamental biological divide between the two respiratory conditions.

At the GOLD 2026 COPD International Conference in Philadelphia, researchers addressed why the transition from asthma-focused medicine to COPD-focused medicine has been so difficult. The core issue lies in how inflammation manifests in each disease.

Type 2 inflammation differs by disease

In most asthma patients, Type 2 inflammation is the dominant biological process. However, Singh says Type 2 inflammation is only one component of the complex inflammation in COPD.

This distinction explains why biologics that show massive success in asthma trials often produce smaller effect sizes in COPD populations. The underlying biology simply isn’t as uniform.

“Type 2 inflammation is one component of COPD but the dominant process in most patients with asthma,” Singh explained.

Because COPD involves multiple inflammatory pathways, a drug targeting only one specific Type 2 pathway may not provide enough relief for many patients. This complexity means a “one size fits all” approach to biologics is unlikely to work for the COPD community.

Moving toward precision prediction

Clinicians are currently weighing two distinct methods for determining which patients will actually benefit from these expensive, specialized treatments. The first approach is empiric treatment, where a doctor prescribes the biologic and then assesses the patient’s response over time.

This method has major drawbacks. It requires time to see if the drug works, and the definition of a “successful response” can vary between patients and providers. The second, and currently preferred, method is prediction based on clinical characteristics and specific biomarkers.

By identifying specific biological signatures before treatment begins, doctors hope to match the right patient to the right drug. This precision is the primary goal as the field attempts to refine the use of biologics in COPD.

The potential of anti-alarmin therapy

Because some patients may suffer from both Type 2 and non-Type 2 inflammation simultaneously, researchers are looking toward broader solutions. Singh identified anti-alarmin therapy as a potential answer to this challenge.

Unlike some current biologics that target a single downstream cytokine, anti-alarmin therapies can act on both Type 2 and non-Type 2 inflammatory pathways. This dual action could potentially address the multifaceted nature of COPD inflammation more effectively than current options.

The shift toward these broader therapies represents a move away from narrow targeting and toward a more holistic understanding of respiratory pathology. If successful, this could bridge the gap between the successes seen in asthma and the ongoing struggles in COPD management.

The medical community continues to monitor how these biomarker-driven strategies evolve as new treatments enter the clinical pipeline.

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