Abstract
Objectives: The study compared triple therapy (inhaled corticosteroids/long-acting beta2-agonists [LABA]/long-acting muscarinic antagonists [LAMA]) versus dual therapy [LABA/LAMA] in improving lung function and health-related quality of life (HRQoL) of patients with chronic obstructive pulmonary disease (COPD).
 Methods: This prospective and observational study compared 12 weeks of triple therapy (Formoterol – 6 mcg/Ciclesonide – 200 mcg/Tiotropium – 9 mcg) versus dual therapy (Formoterol – 6 mcg/Tiotropium – 9 mcg) in COPD patients. The primary objective included HRQoL as measured by improvement (decrease) from baseline in St. George respiratory questionnaire (SGRQ) score and COPD assessment test (CAT) scores. Coprimary endpoint included the change from baseline in forced expiratory volume in 1 second (FEV1).
 Results: After 12 weeks of treatment, triple therapy (n=30) and dual therapy (30), mean improvement (decrease) from baseline in SGRQ scores was −21.06 (95% CI, −24.92–−17.20) and −5.89571 (95% CI, −7.71–−4.07), respectively, and mean improvement (decrease) from baseline in CAT scores was −2.83 (95% CI, −3.73–−1.94] and −1.8 (95% CI, −2.25–−1.35), respectively. The mean change from baseline in FEV1% predicted was 3.09 (95% CI, 2.18–4.00) and 1.69 (95% CI, 1.43–1.97) for triple and dual therapy, respectively. For all the endpoints, the between-group mean differences were statistically significant (p<0.001).
 Conclusion: Triple therapy (Formoterol – 6 mcg/Ciclesonide – 200 mcg/Tiotropium – 9 mcg) can provide improvements in lung function and quality of life over dual therapy (Formoterol – 6 mcg/Tiotropium – 9 mcg) in patients with moderate to severe COPD. Future studies should focus on which drug combination of triple therapy is more effective and cost-effective than other possible triple therapy drug combinations.
Highlights
Chronic obstructive pulmonary disease (COPD) is a disorder of gradual lung function loss developing due to increasing breathing restrictions
St. George respiratory questionnaire (SGRQ) scores The mean change from baseline in SGRQ scores was −21.06 and −5.89571 for triple therapy and dual therapy, respectively
The overall benefit of response versus non-response was statistically significant in favor of triple therapy (Fig. 4)
Summary
Chronic obstructive pulmonary disease (COPD) is a disorder of gradual lung function loss developing due to increasing breathing restrictions. Different combinations of long-acting beta2-agonists (LABA), inhaled corticosteroids (ICS), and long-acting muscarinic antagonists (LAMA) have been compared. These explorations proved triple therapy to be beneficial than dual therapy in terms of improvements in lung function, but variable results were obtained when the health-related quality of life (HRQoL) was concerned [3,4]. Research has shown that COPD patients had deteriorated HRQoL [5,6] In this regard, St. George respiratory questionnaire (SGRQ) and COPD assessment test (CAT) have been validated and used extensively in clinical trials [7,8,9,10]. HRQoL measures such as SGRQ and CAT scores along with objective parameters like spirometry can provide exhaustive coverage of treatment response following drug therapy [15]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
