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The 2024\u20132026 period represents a historic inflection point: three mechanistically distinct agents received Food and Drug Administration approval, marking the first substantive pharmacological innovation in over two decades and catalyzing a fundamental paradigm shift from empirical symptom management towards biomarker\u2010driven, pathobiology\u2010aligned precision medicine. In this comprehensive review, we synthesized emerging evidence on novel COPD therapeutics, encompassing dual phosphodiesterase\u20103\/4 inhibitors, biologics targeting type 2 inflammatory pathways (interleukin [IL]\u20104\/IL\u201013 and IL\u20105 axes), upstream alarmin antagonists (IL\u201033 and thymic stromal lymphopoietin), and emerging technologies including gene editing and senolytic therapy. We evaluated randomized controlled trials reporting reductions in exacerbations with biologic therapy in eosinophil\u2010enriched populations. 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