Clinical Edge

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Triple Inhaled Therapy in COPD Patients

One fifth of primary care patients with chronic obstructive pulmonary disease (COPD) are prescribed with triple inhaled (TI) therapy over 4.5 years, a new study found. The study examined the incidence and determinants of the TI therapy in a cohort of patient with COPD, prescribed for the first time with inhaled treatments, and followed-up between January 2002 - December 2014. The primary outcome was the first incident prescription of a TI therapy. Researchers found:

  • Of 17,589 patients (mean age 71.1 years, 37.4% female), 21% were prescribed with a TI therapy during follow-up.
  • Older age, cigarette smoking, COPD severity and heart failure were significantly associated with an escalation to the TI therapy.
  • Female sex and some comorbidities were negatively associated with the outcome.
  • Patients initially treated with long-acting muscarinic antagonists (LAMA) and long-acting beta agonists/inhaled corticosteroids (LABA/ICS) were more likely to escalate to the TI therapy vs those on LABA.

Citation:

Vetrano, DL. Triple inhaled therapy in COPD patients: Determinants of prescription in primary care. [Published online ahead of print May 29, 2019]. Respir Med. doi: 10.1016/j.rmed.2019.05.022.