Triple therapy for asthma in a single inhaler!
For a patient whose asthma is not controlled by medium-to-high–dose inhaled corticosteroids (ICS) and a long-acting ß-agonist (LABA), current guidelines e.g., Global Initiative for Asthma recommend adding a long-acting antimuscarinic agent (LAMA). In two industry-sponsored European trials, which differed only in whether medium- or high-dose beclomethasone was used, researchers examined whether a single inhaler that contained ICS plus a LABA and a LAMA worked better than an inhaler that contained ICS/LABA.
More than 2,500 patients were randomised to beclomethasone, formoterol (a LABA), and glycopyrronium (a LAMA) in a single, ultra-fine, metred-dose inhaler (triple-therapy groups) or to beclomethasone and formoterol in a single inhaler (dual-therapy groups). After 26 weeks, mean improvement in pretreatment FEV1 (forced expiratory volume in 1 second) improved more with triple therapy than with dual therapy (by ≈60–70 mL).
Although this study only showed modest improvements in lung function and exacerbation prevention, an FDA-approved triple-therapy option in a single inhaler for asthma would be convenient. The only currently available triple inhaler in the U.S. (Trelegy Ellipta) is approved for use only in patients with chronic obstructive pulmonary disease.
Comments