Efficacy of Serum Bovine Immunoglobulin in Improving Nutritional Status in Advanced COPD

Inclusion Criteria:

- Age between age 30 and 80 at Baseline Visit

- Diagnosed with 2012 spirometric COPD GOLD Stage 3 (FEV1/FVC ratio <0.70, FEV1 30-49%
of normal) or GOLD Stage 4 (FEV1/FVC <0.70, FEV1 <30% of normal or FEV1<50% of normal
with chronic respiratory failure present)

- Able to tolerate and willing to undergo study procedures

- Body Mass Index below 21

- Signed Informed Consent

Exclusion Criteria:

- History of comorbid condition severe enough to significantly impact 6 months outcomes

- Current substance abuse, including tobacco, alcohol and illicit drugs

- Diagnosis of unstable cardiovascular disease including myocardial infarction in the
past 6 weeks, uncontrolled congestive heart failure, or uncontrolled arrhythmia

- Dementia or other cognitive dysfunction which in the opinion of the investigator
would prevent the participant from consenting to the study or completing study
procedures

- Active pulmonary infection with tuberculosis

- Non-COPD obstructive lung disease (various bronchiolitides, sarcoidosis, LAM,
histiocytosis X) or parenchymal lung disease, pulmonary vascular disease, pleural
disease, severe kyphoscoliosis, neuromuscular weakness, or other cardiovascular and
pulmonary disease, that limit the interpretability of the pulmonary function measures

- Prior significant difficulties with pulmonary function testing

- Hypersensitivity to or intolerance of albuterol sulfate or ipratropium bromide or
propellants or excipients of the inhalers, or to beef

- History of lung or other organ transplant

- Currently taking >20mg of prednisone or equivalent systemic corticosteroid

- Currently taking any immunosuppressive agent

- History of lung cancer or any cancer that spread to multiple locations in the body

- Known HIV/AIDS infection

- History of or current exposure to chemotherapy or radiation treatments that, in the
opinion of the investigator, limits the interpretability of the pulmonary function
measures.

- Current or planned pregnancy within the study course.

- Currently institutionalized (e.g., prisons, long-term care facilities)