The Use of Triple Therapy in Chronic Obstructive Pulmonary Disease and Outcomes of the IMPACT Trial

Abstract

Triple inhaled therapy for chronic obstructive pulmonary disease (COPD) comprises the combination of an inhaled corticosteroid (ICS), a long-acting β2-agonist (LABA) and a long-acting muscarinic antagonist (LAMA). The use of triple therapy is recommended by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) for patients who experience recurrent exacerbations despite treatment with either a dual bronchodilator or LABA/ICS combination.1 Evidence exists for the superior efficacy of triple therapy compared with LABA/ICS and LAMA monotherapy with regards to improved lung function, health status, and exacerbation rate. However, the benefits of triple therapy compared with dual bronchodilation (LABA/LAMA) are uncertain.2 The IMPACT study compared triple therapy and dual inhaler therapy comprising LABA/LAMA in patients with COPD.3 In an expert interview, Dr Cazzola discusses this study and its implications for clinical practice.