Do you offer dupilumab to patients with COPD and eosinophilia who are not on inhaled triple therapy?

I recently tried this due to inhaler/nebulizer intolerance in such a patient and it was refused by insurance.

It makes sense from a pathophysiological perspective, and is why I do not tend to wean biologics off my asthma patients if they achieve clinical stability on it. But I do not think most insu...