Triple Therapy for COPD Patients

Guidelines recommend stepwise treatment for patients with chronic obstructive pulmonary disease (COPD) based on symptoms and exacerbation risk: Start with a long-acting antimuscarinic agent (LAMA) or a long-acting β-agonist (LABA); then, combine the two; and finally, add an inhaled corticosteroid (ICS) for those whose COPD still is uncontrolled. However, triple therapy (i.e., LAMA plus LABA plus ICS) was not studied intensively until this year.

In 1532 symptomatic COPD patients with ≥2 exacerbations in the past year, triple therapy (beclomethasone, formoterol, and glycopyrrolate) for 1 year prevented some moderate-to-severe exacerbations compared with dual therapy (indacaterol and glycopyrrolate); the number needed to treat was 11 to prevent…