Treatment Combo for COPD Exacerbations Is Safe

The combination of beclometasone dipropionate, formoterol fumarate, and glycopyrronium (BDP/FF/G) is associated with reduced moderate to severe exacerbations compared with indacaterol plus glycopyrronium (IND/GLY) in patients with chronic obstructive pulmonary disease (COPD), a new study found.

For their study, the researchers assessed 1532 patients with symptomatic COPD, severe or very severe airflow limitation, and at least 1 moderate or severe exacerbation within the last year who were receiving inhaled maintenance therapy.
_____________________________________________________________________________

RELATED CONTENT
Exacerbation Risk Predictors Identified for COPD Patients
FDA Approves New Option for COPD
_____________________________________________________________________________

Patients were first treated with 1 inhalation of 85 μg IND/43 μg GLY per day for a 2-week run period. Subsequently, patients were randomly assigned to be treated with either 2 twice-daily inhalations of extrafine 87 μg BDP/5 μg FF/9 μg G (n = 764) or 1 once-daily inhalation of 85 μg IND/43 μg GLY for 52 weeks (n = 768).

Results showed that moderate to severe exacerbation rates were 0.50 per patient per year for BDP/FF/G and 0.59 for IND/GLY, with a rate ratio of 0.848 in favor of BDP/FF/G.

The researchers noted that 490 (64%) patients treated with BDP/FF/G and 516 (67%) patients treated with IND/GLY experienced adverse events including pneumonia (28 vs 27 patients). In addition, 1 patient treated with BDP/FF/G developed dysuria, and another treated with IND/GLY experienced atrial fibrillation.

“In patients with symptomatic COPD, severe or very severe airflow limitation, and an exacerbation history despite maintenance therapy, extrafine BDP/FF/G significantly reduced the rate of moderate-to-severe exacerbations compared with IND/GLY, without increasing the risk of pneumonia,” the researchers concluded.

—Christina Vogt

Reference:

Papi A, Vestbo J, Fabbri L, et al. Extrafine inhaled triple therapy versus dual bronchodilator therapy in chronic obstructive pulmonary disease (TRIBUTE): a double-blind, parallel group, randomized controlled trial [Published online February 8, 2018]. Lancet. https://doi.org/10.1016/S0140-6736(18)30206-X.