Triple Therapy Tied to Reduced Rate of COPD Exacerbations

Benefits seen for triple therapy with fluticasone furoate, umeclidinium, and vilanterol
Benefits seen for triple therapy with fluticasone furoate, umeclidinium, and vilanterol

HealthDay News — For patients with chronic obstructive pulmonary disease (COPD), triple therapy is associated with a reduced rate of exacerbations, according to a study published online April 18 in the New England Journal of Medicine.

David A. Lipson, MD, from GlaxoSmithKline in Collegeville, Pennsylvania, and colleagues conducted a randomized trial involving 10,355 patients with COPD. Fifty-two weeks of a once-daily combination of fluticasone furoate (an inhaled glucocorticoid), umeclidinium (a long-acting muscarinic antagonist), and vilanterol (a long-acting β2-agonist) was compared with fluticasone furoate-vilanterol and umeclidinium-vilanterol. Each of the regimens was administered in a single inhaler. 

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The researchers found that the rate of moderate or severe exacerbations was 0.91 per year in the triple-therapy group, compared with 1.07 in the fluticasone furoate-vilanterol group (rate ratio with triple therapy, 0.85) and 1.21 in the umeclidinium-vilanterol group (rate ratio with triple therapy, 0.75). The annual rate of severe exacerbations resulting in hospitalization was 0.13 in the triple therapy group, compared with 0.19 in the umeclidinium-vilanterol group (rate ratio, 0.66). The incidence of pneumonia was higher in the inhaled-glucocorticoid groups than in the umeclidinium-vilanterol group. A significantly higher risk of clinician-diagnosed pneumonia was seen with triple therapy versus umeclidinium-vilanterol (hazard ratio, 1.53).

"Triple therapy with fluticasone furoate, umeclidinium, and vilanterol resulted in a lower rate of moderate or severe COPD exacerbations than fluticasone furoate-vilanterol or umeclidinium-vilanterol in this population," the authors write.

Several authors disclosed financial ties to GlaxoSmithKline, which funded the study.

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