Triple therapy in COPD: understanding the data

Abstract

The recommended pharmacological treatment for a patient first diagnosed with COPD is a long-acting bronchodilator, either long-acting muscarinic antagonists (LAMA), long-acting β ₂-agonists (LABA) or their combination [1]. For patients with high blood eosinophil counts (>300 cells per μL), an inhaled corticosteroid (ICS) combined with a LABA (LABA-ICS) is considered. In follow-up management, dual (LAMA-LABA and LABA-ICS) and triple combinations (LAMA-LABA-ICS) of these drug classes are recommended if these initial treatments become ineffective, according to the degree of dyspnoea and the frequency of exacerbations. Currently, several single-inhaler combinations of these three treatment classes are available, including single-inhaler triple therapy.

Abstract

Effectiveness of single-inhaler triple therapy on exacerbation risk and mortality in COPD is exaggerated in IMPACT and ETHOS trials from confounding by prior ICS discontinuation: effectiveness fades in analyses and studies with no prior ICS discontinuation https://bit.ly/3tOgNdW