Combination triple therapy has been proven to reduce mortality, hospital admissions and exacerbations in patients with chronic obstructive pulmonary disease (COPD), according to a recent study published in CHEST.
While physicians commonly use triple therapy with inhaled corticosteroids, beta-agonists and antimuscarinics for COPD, researchers argue that this therapy has been used with limited scientific support. However, the study supports that this treatment is effective in the treatment of the disease.
Researchers studied patients diagnosed with COPD in the NHS Tayside Respiratory Disease Information System between 2001 and 2010. Patients were divided into two groups based on their use of dual or triple therapy and statistical analysis used to calculate hazard rations for all-cause mortality hospital admissions due to respiratory disease, and emergency oral steroid use, to treat exacerbations.
Of the patients, 1,857 were prescribed triple therapy—defined as any combination of inhaled steroid, a long-acting bet-agonist and tiotropium—while 996 were prescribed dual therapy with an inhaled steroid and long-acting beta-agonist. Researchers noted that the patients who received triple therapy had more severe COPD compared to the dual therapy group.
After adjusting for factors such as history of disease, age, sex and smoking status, researchers found that the addition of tiotropium to dual therapy reduced the risk of death from any cause by 35%. Additionally, researchers analyzed a subgroup of patients to determine if triple therapy reduced the risk of death due to respiratory or cardiovascular disease. Findings show that adding the third drug reduced the risk of death from respiratory disease by 30% and cardiovascular disease by 51%.
Risk of COPD exacerbations was also reduced by 29%, while the risk of being admitted to the hospital due to respiratory disease was reduced by 15%. Researchers note that while triple therapy reduces a number of negative repercussions of the disease, there were no clinically relevant changes found in lung function between the two groups.