Triple-Therapy Inhaler Tied to Better Lung Function in Asthma

By Kelly Young

Edited by David G. Fairchild, MD, MPH

A single-inhaler triple therapy is associated with improved lung function and lower exacerbation risk in patients with asthma, according to two industry-funded studies presented at the European Respiratory Society Conference and published in the Lancet.

Researchers enrolled adults with uncontrolled asthma who were taking a stable dose of an inhaled corticosteroid and a long-acting beta-agonist.

In the TRIMARAN study, nearly 1200 patients were randomized to either beclometasone dipropionate plus formoterol fumarate (BDP/FF) or extrafine BDP/FF plus the long-acting muscarinic antagonist glycopyrronium (G), in a single inhaler. In TRIGGER, roughly 1400 were randomized to BDP/FF, extrafine BDP/FF/G, or open-label BDP/FF plus tiotropium.

TRIMARAN patients were on medium doses of inhaled corticosteroids at baseline and received 100 ug BDP, while TRIGGER patients received high baseline doses and 200 ug.

In both studies, BDP/FF/G treatment was associated with greater morning predose FEV1 at week 26, compared with BDP/FF. In TRIMARAN, the BDP/FF/G group also had a 15% lower annualized rate of moderate and severe exacerbations.

Dr. David Amrol will be offering his views in NEJM Journal Watch General Medicine in the coming days. Stay tuned.