The following article features coverage from CHEST 2021, being held virtually from October 17 to October 20, 2021. Click here to read more of MPR‘s conference coverage.

Treatment with once-daily single-inhaler fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) triple therapy appears to be more efficacious in reducing severe exacerbations in patients with chronic obstructive pulmonary disease (COPD) than twice-daily inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) dual therapy. This was among the findings of a post-hoc analysis of the FULFIL trial ( Identifier: NCT02345161) presented at the CHEST Annual Meeting, held virtually and in Orlando, FL, October 17 to 20.

The FULFIL trial is a phase 3, randomized, double-blind trial that demonstrated clinically meaningful and statistically significant improvements in lung function and health-related quality of life as well as reductions in moderate/severe exacerbation annualized rates in patients with symptomatic COPD. The study compared once-daily FF/UMEC/VI triple therapy with twice-daily budesonide/formoterol (BUD/FOR) ICS/LABA dual therapy in patients at risk for COPD exacerbations.

Because severe exacerbations can create a high clinical and financial burden on both patients and health care systems, researchers performed a post hoc analysis of the FULFIL study to examine treatment effects on severe exacerbation rates. They found that 1% of patients on FF/UMEC/VI and 2% of patients on BUD/FOR experienced severe exacerbations up to week 24, which increased to 2% and 9%, respectively, up to week 52. In addition, FF/UMEC/VI reduced severe exacerbation rates compared with BUD/FOR by 51% (mean annualized rate 0.029 vs 0.059, respectively; rate ratio: 0.49; P =.061) up to week 24, and by 67% (mean annualized rate 0.037 vs 0.112, respectively; rate ratio: 0.33; P =.021) up to week 52.

“These results highlight the potential benefits of once-daily single-inhaler FF/UMEC/VI triple therapy over twice-daily ICS/LABA dual therapy in reducing the clinical and economic burden caused by severe exacerbations in this patient population,” concluded the investigators.

Disclosure: This research was supported by GlaxoSmithKline. Please see the original reference for a full list of disclosures.


Panettieri R, Bangalore M, Camargo C, et al. Effect of once-daily single-inhaler fluticasone furoate/umeclidinium/vilanterol triple therapy on severe exacerbation rates compared with twice-daily budesonide/formoterol dual therapy in patients with COPD: a post hoc analysis of the FULFIL study. Presented at: CHEST 2021; October 17-20, 2021; Orlando, FL/Virtual. Abstract A1818-A1821.

This article originally appeared on Pulmonology Advisor