We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Impact of triple therapy on mortality in COPD.
- Authors
Soumagne, Thibaud; Zysman, Maeva; Karadogan, Dilek; Lahousse, Lies; Mathioudakis, Alexander G.
- Abstract
Only a few therapies have been shown to prolong survival in specific patients with COPD. In recent years, the IMPACT and the ETHOS trials suggested that triple therapy (a combination of inhaled corticosteroid (ICS), long-acting muscarinic antagonist (LAMA) and long-acting β2-agonist (LABA) given in a single inhaler) may reduce mortality compared with dual bronchodilation. These results need however to be interpreted with caution. These trials were not powered by design to evaluate the impact of triple therapy on mortality as mortality was a secondary outcome. In addition, mortality reduction has to be put in perspective with the low mortality rate in both studies (<2%). Furthermore, a key methodological issue is that up to 70--80% of patients had ICS withdrawal at the enrolment in the LABA/LAMA arms, but none in the ICS-containing treatment arms. It is possible that ICS withdrawal may have contributed to some early death events. Finally, the inclusion and exclusion criteria of both trials were designed to select patients likely to respond to ICS. There are no conclusive data yet that triple therapy reduces mortality in COPD. Future, well-designed and -powered trials are needed to validate the findings on mortality.
- Subjects
GLUCOCORTICOIDS; ADRENERGIC beta agonists; EXPERIMENTAL design; COMBINATION drug therapy; RESEARCH methodology; GLYCOPYRROLATE; SEVERITY of illness index; BRONCHODILATOR agents; TREATMENT effectiveness; OBSTRUCTIVE lung diseases; CONTROLLED release preparations; FLUTICASONE; FORCED expiratory volume; INHALATION administration; MUSCARINIC antagonists; BUDESONIDE; DISEASE exacerbation; THERAPEUTICS
- Publication
Breathe, 2023, Vol 19, Issue 1, p1
- ISSN
1810-6838
- Publication type
Article
- DOI
10.1183/20734735.0260-2022