Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

COPD Triple-Therapy Combinations and Related Symptoms

In an observational review that measured the effect of changing chronic obstructive pulmonary disease (COPD) triple-therapy inhaler combinations on COPD symptoms, no significant change in patient-reported symptom scores was noted. A quality improvement program was instituted to reduce drug costs associated with COPD inhalers between fall 2016 and spring 2017. Patients identified as taking an inhaled corticosteroid (ICS)/long-acting β-agonist (LABA) inhaler and a long-acting muscarinic agonist (LAMA) inhaler were changed to a LAMA/LABA inhaler and an ICS inhaler. Symptoms were assessed at baseline and subsequent follow-up using the COPD Assessment Test (CAT), with lower scores representing better symptom control. Among the findings:

  • Of 118 patients included in the program, 19 met inclusion and exclusion criteria.
  • The mean CAT score prior to the change was 15.53, and the mean CAT score after the change was 14.68.
  • Symptom scores improved after the change, although the change was not statistically significant.


Ladziak N, Albanese NP. Effect of changing COPD triple-therapy inhaler combinations on COPD symptoms. Am J Manag Care. 2019;25(4):201-204.