Abstract
Objective: The present study was conducted with the objective of analyzing the efficacy of triple-drug combination therapy (formoterol, ciclesonide, tiotropium) by comparing it with double drug combination therapy (formoterol, budesonide).Methods: A prospective observational study was conducted. Sixty patients were enrolled, and divided into two groups of thirty each; one group was treated with the double-drug and the other with a triple drug combination. FEV1 and FVC pre-and post-treatment in either group were assessed spirometrically. Score ranges of 0-10, 11-20 and 21-30 were allotted to mild, moderate and severe categories and results were analyzed statistically.Results: Of the 60 patients recruited, 61-70 y olds constituted the majority (35%) of the population. Males (63.3%) were more in number compared to females (36.6%). Twenty-three of thirty-eight men smoked (60.5%); there were no female smokers. Common symptoms included cough (93.3%), dyspnoea (85%), fever (45%) and haemoptysis (15%). Hypertension accounted for 70% of patient comorbidities, followed by diabetes (60%) and cardiovascular diseases (40%). Three months after treatment with triple therapy, a significant increase in the differences of means of both FEV1 (14.27) and FVC (14.90) values was observed. Further analysis based on score ranges demonstrated that triple therapy administration markedly reduced the number of patients suffering from severe COPD.Conclusion: Our comparative analysis indicated that triple therapy was more effective in improving lung function, enhancing patients’ quality of life (evidenced from score ranges) thereby reducing mortality. While much is known about the greater effectiveness of triple over dual therapy, researchers to formulate the most effective triple therapy are in progress.
Highlights
The history of Chronic obstructive pulmonary disease (COPD) can be traced back to Dr Rene Laënnec, who was the first to precisely establish a relationship between chronic bronchitis and emphysema [1]
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) defines COPD as “common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases” [5]
Our data suggested that the triple drug combination of formoterol, ciclesonide and tiotropium showed more efficacy in patients suffering from COPD than the dual drug combination of formoterol and budesonide
Summary
The history of COPD can be traced back to Dr Rene Laënnec, who was the first to precisely establish a relationship between chronic bronchitis and emphysema [1]. In 1962, the American Thoracic Society Committee defined emphysema as “an anatomic alteration of the lung characterized by an abnormal enlargement of the airspace distal to the terminal, non-respiratory bronchiole accompanied by destruction of the alveolar walls” [3]. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) defines COPD as “common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases” [5]. Analogous to the discovery of COPD which coursed gradually through decades, the establishment of a peculiar treatment therapy for the disease took years to develop. By the end of the twentieth century, available treatment options included smoking cessation, antibiotics, bronchoactive agents and steroids [7]
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