NICE has approved dupilumab (Dupixent from Sanofi) as adjunctive maintenance therapy for adult patients with uncontrolled COPD characterized by elevated blood eosinophil levels (≥300 cells/μL).[1][2] It is the first biologic treatment targeted at this type of COPD, given by injection every two weeks.[1][3] The treatment reduces COPD flare-ups by about a third and improves lung function, as shown by the phase 3 BOREAS and NOTUS trials.[1][2][4] An estimated 1.2 million people in the UK have a diagnosis of COPD, with approximately 40% of these having elevated blood eosinophils.[1] The approval will enable use in the NHS in England and Wales, with funding expected within 90 days in England and 60 days in Wales following final guidance.[1][2] Dupilumab is added to triple therapy (ICS + LABA + LAMA) or double therapy (LABA + LAMA) if ICS is not suitable.[1][3] Approval may reduce emergency hospitalizations and provides a new option for patients with limited treatment options.[1]