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Triple therapy (ICS/LABA/LAMA) in COPD: thinking out of the box

Lowie E.G.W. Vanfleteren, Anders Ullman, Anita Nordenson, Anders Andersson, Kristina Andelid, Leonardo M. Fabbri
ERJ Open Research 2019 5: 00185-2018; DOI: 10.1183/23120541.00185-2018
Lowie E.G.W. Vanfleteren
COPD center, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
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  • ORCID record for Lowie E.G.W. Vanfleteren
  • For correspondence: lowie.vanfleteren@vgregion.se
Anders Ullman
COPD center, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
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Anita Nordenson
COPD center, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
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Anders Andersson
COPD center, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
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Kristina Andelid
COPD center, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
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Leonardo M. Fabbri
COPD center, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
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Extract

A current hot topic in COPD is that two “fixed triple” combinations of an inhaled corticosteroid (ICS), a long-acting β2-agonist (LABA) and a long-acting muscarinic antagonist (LAMA) in a single inhaler have become available for patients with COPD, and a third triple therapy is in advanced development with the first large randomised clinical trial (RCT) recently published in Lancet Respiratory Medicine [1]. The triple therapies available in a single inhaler are: beclomethasone-dipropionate/formoterol/glycopyrronium (BDP/FF/G); fluticasone-furoate/vilanterol/umeclidinium (FLF/VI/UMEC); and budesonide/glycopyrronium/formoterol (B/G/F).

Abstract

Triple inhaler therapy in COPD might in some real-life situations be useful outside of the strict indications reported by the registration agencies, but at the same time in some other situations it could be better avoided, even when recommended http://ow.ly/CbOe30njXV2

Footnotes

  • Conflict of interest: L.E.G.W. Vanfleteren reports personal fees from AstraZeneca, Chiesi, Pulmonx, GlaxoSmithKline, and Novartis, outside the submitted work.

  • Conflict of interest: A. Ullman reports grants from AstraZeneca and Novartis, grants and personal fees from GSK and Boehringer, personal fees from Chiesi, other from Verona Pharm (COPD product in phase II, board member), outside the submitted work.

  • Conflict of interest: A. Nordenson reports personal fees from Chiesi, GlaxoSmithKline, Novartis, and Boehringer Ingelheim, outside the submitted work.

  • Conflict of interest: A. Andersson reports personal fees from AstraZeneca, Novartis, and Teva, outside the submitted work.

  • Conflict of interest: K. Andelid reports personal fees from GlaxoSmithKline, Novartis, and Boehringer Ingelheim, outside the submitted work.

  • Conflict of interest: L.M. Fabbri reports personal fees and non-financial support from AstraZeneca, GSK, Novartis, Menarini, Boehringer Ingelheim, Zambon and Pearl Therapeutics, grants, personal fees and non-financial support from Chiesi, and non-financial support from Dompe, outside the submitted work.

  • Received October 16, 2018.
  • Accepted December 19, 2018.
  • Copyright ©ERS 2019

This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

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Triple therapy (ICS/LABA/LAMA) in COPD: thinking out of the box
Lowie E.G.W. Vanfleteren, Anders Ullman, Anita Nordenson, Anders Andersson, Kristina Andelid, Leonardo M. Fabbri
ERJ Open Research Feb 2019, 5 (1) 00185-2018; DOI: 10.1183/23120541.00185-2018

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Triple therapy (ICS/LABA/LAMA) in COPD: thinking out of the box
Lowie E.G.W. Vanfleteren, Anders Ullman, Anita Nordenson, Anders Andersson, Kristina Andelid, Leonardo M. Fabbri
ERJ Open Research Feb 2019, 5 (1) 00185-2018; DOI: 10.1183/23120541.00185-2018
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  • Article
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    • Possible use of triple therapy outside of the recommendations
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  • Pneumonia in exacerbations of COPD
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