Novel therapeutic targets and drug development for the precision treatment of COPD

Introduction: Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality, morbidity, and health care expenditures worldwide. Because of the heterogeneity of COPD, subjective approach to its treatment is often unsuccessful in achieving optimal outcomes. Better understanding of its pathophysiologic mechanism may pave a more precise therapeutic approach. Such an approach should ideally consider the individual variability and incorporate the genetics, endotypes, and psychosocial aspect of the disease and indeed has become the focus of many therapeutic targets in development.Areas covered: The complexity and heterogeneity of COPD prompted the identification of several phenotypes and biomarker-based endotypes that reflect underlying pathobiological mechanisms. Although still in its infancy, precision medicine approach to treat COPD will ensure treating the right patient at the right time with the right medicine. In this review, we highlight some emerging therapeutic targets for the precision treatment of COPD.Expert opinion: Few existing therapies for COPD thus far employ a precision approach taking the individual variability of response to treatments into account. Unfortunately, biomarkers to identify different subtypes of COPD are not yet widely available. The use of such biomarkers would ensure successful drug development programs and are important for clinicians managing patients with this heterogenous disease.