Can You Safely Withdraw COPD Patients from Triple Therapy?

For a patient with moderate-to-severe chronic obstructive pulmonary disease (COPD) and frequent exacerbations despite combined bronchodilator therapy with a long-acting antimuscarinic antagonist (LAMA) and a long-acting β-agonist (LABA), triple therapy with an inhaled corticosteroid (ICS) is recommended. However, in current practice, many patients with nonfrequent exacerbations also receive triple therapy. In an industry-supported study, researchers examined whether the ICS component could be withdrawn safely.

A cohort of 1053 triple-therapy patients with moderate-to-severe COPD and infrequent exacerbations were randomized to two treatment arms: to continue triple therapy (tiotropium [Spiriva] once daily plus salmeterol/fluticasone propionat…