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In Group D patients with exacerbations and symptoms not controlled with long-acting β-agonists (LABAs) plus long-acting muscarinic-receptor antagonists (LAMAs), the Global Initiative for Obstructive Lung Disease (GOLD) recommends adding inhaled corticosteroids (ICS) — i.e., triple therapy (NEJM JW Gen Med Jun 15 2017 and Am J Respir Crit Care Med 2017; 195:557). To evaluate this recommendation, researchers conducted a meta-analysis of 21 trials in which triple therapy was compared with mono- or dual therapy in patients with moderate-to–very severe chronic obstructive pulmonary disease (COPD) and at least one exacerbation in the previous year.
Triple therapy was compared with LAMA monotherapy in 10 trials, with LAMA/LABA combinations in 3 tri…