Triple Therapy for Asthma in a Single Inhaler

For a patient whose asthma is not controlled by medium-to-high–dose inhaled corticosteroids (ICS) and a long-acting β-agonist (LABA), current guidelines (e.g., Global Initiative for Asthma recommend adding a long-acting antimuscarinic agent (LAMA). In two industry-sponsored European trials, which differed only in whether medium- or high-dose beclomethasone was used, researchers examined whether a single inhaler that contained ICS plus a LABA and a LAMA worked better than an inhaler that contained ICS/LABA.

More than 2500 patients were randomized to beclomethasone, formoterol (a LABA), and glycopyrronium (a LAMA) in a single, ultra-fine, metered-dose inhaler (triple-therapy groups) or to beclomethasone and formoterol in a single inhaler (dual…