In another landmark for GSK’s blockbuster respiratory drug, Nucala (mepolizumab), the UK’s health watchdog has recommended the therapy’s use by the UK National Health Service (NHS) in patients with chronic obstructive pulmonary disease (COPD).
In draft guidance debuted by the UK National Institute for Health and Care Excellence (NICE), the health agency endorsed Nucala’s use in adult patients with uncontrolled COPD characterised by raised blood eosinophils. This means that patients using the NHS will have access to the IL-5 blocker as an add-on maintenance option alongside standard of care (SoC) triple inhaled therapy.
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NICE based its decision on the outcome of the MATINEE (NCT04133909), METREX (NCT02105948) and METREO (NCT02105961) studies, in which Nucala reduced yearly COPD exacerbations by up to 21% alongside SoC versus placebo and SoC, while significantly extending a patient’s time to first exacerbation.
Nucala, which first secured NICE’s recommendation back in 2016 for severe eosinophilic asthma, is administered subcutaneously on a four-weekly basis. Patients also have the option to self-inject the therapy after the appropriate training.
According to Richard Russell, Professor of Respiratory Medicine at King’s College London, Nucala’s NHS use holds the potential to both improve outcomes and “ease pressure on the healthcare system by reducing hospitalisations”.
While Nucala marks the latest addition to the NHS’s COPD treatment arsenal, it is not the only therapy for this indication that NICE has recently given the go-ahead to. In March 2026, the health watchdog debuted final guidance on the use of Sanofi’s Dupixent (dupilumab) in the same population it recommended Nucala for, after originally rejecting the drug back in 2018.
Fulfilling unmet needs in COPD
While Sarah Sleet, CEO of Asthma + Lung UK, heralds NICE’s positive take on Nucala as a “significant milestone for COPD treatment”, she notes that fewer than 10% of patients with the condition receive “the basic care they need to stay well”.
Sleet adds that only some people with uncontrolled COPD will be eligible for treatment with Nucala, meaning more research is necessary to find new treatments for the condition.
As per GlobalData’s Pharmaceutical Intelligence Center, there are eight biologic COPD candidates currently progressing through Phase III clinical trials.
This includes Amgen and AstraZeneca’s thymic stromal lymphopoietin (TSLP) blocker, Tezspire (tezepelumab), which made it to Phase III in COPD, despite missing its primary endpoint in a mid-stage study.
GSK is also looking to extend Nucala’s legacy with ultra-long-acting successor and fellow IL-5 inhibitor, Exdensur (depemokimab), which secured the US regulatory approval in severe asthma back in 2025. The British pharma is currently evaluating the drug’s potential in the Phase III ENDURA programme.
According to a report from GlobalData, the parent company of Pharmaceutical Technology, analysts expect the COPD market to grow to a value of $30.2bn in 2033.
