Chronic obstructive pulmonary disease: Triple inhaled therapy (corticosteroids, beta2 agonists, anticholinergics) VS. Dual therapy for Long-term Tt
DISEASE INTERVENTION COMPARISON RESULTS
N Engl J Med. 2018 Apr 18. doi: 10.1056/NEJMoa1713901. [Epub ahead of print] Randomized Controlled Trial, Multicenter Study
IN chronic obstructive pulmonary disease, stable The Use of
triple inhaled therapy (glucocorticoid - fluticasone, long-acting muscarinic antagonist (LAMA) - umeclidinium, and a long-acting β2-agonist (LABA) - vilanterol)
As Treatment, Chronic
Is better Than
any dual therapy combination
To reduce the annual rate of moderate or severe exacerbations: 0.9 triple tt VS. 1.1 dual tt. Higher risk of pneumonia in dual or triple Tt taking glucocorticoids.
Am J Respir Crit Care Med. 2009 Oct 15;180(8):741-50 Randomized Controlled Trial, Multicenter Study
IN chronic obstructive pulmonary disease, stable The Use of
corticosteroids, inhaled (budesonide), combined with inhaled long-acting beta2 agonists (formoterol), added to inhaled long-acting anticholinergics (tiotropium)
As Treatment, Chronic
Is better Than
placebo plus tiotropium
To improve, at 3 months, VEMS (1.14 cortics/beta2 VS 1.08 placebo), improve respiratory symptoms and reduce exacerbations (8% cortics/beta2 VS 18% placebo)