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Triple Therapy Cuts Mortality in Patients With Symptomatic COPD

All-cause mortality risk significantly lower for triple-drug regimen versus one of two dual-drug regimens

TUESDAY, March 24, 2020 (HealthDay News) — A once-daily, three-drug combination treatment reduces mortality for patients with symptomatic chronic obstructive pulmonary disease (COPD) who are at risk for future exacerbations, according to a study published online March 12 in the American Journal of Respiratory and Critical Care Medicine.

David A. Lipson, M.D., from GlaxoSmithKline in Collegeville, Pennsylvania, and colleagues reported all-cause mortality (ACM) and the impact of stepping down therapy following collection of additional vital status data from the phase 3 IMPACT trial. Patients had been randomly assigned (2:2:1) to fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI), FF/VI, or UMEC/VI following an exacerbation on their COPD therapies.

The researchers found that among 10,355 participants, there were 98 deaths (2.36 percent) on FF/UMEC/VI, 109 deaths (2.64 percent) on FF/VI, and 66 deaths (3.19 percent) on UMEC/VI. Corresponding hazard ratios for death were 0.72 for FF/UMEC/VI versus UMEC/VI (95 percent confidence interval, 0.53 to 0.99; P = 0.042) and 0.89 for FF/UMEC/VI versus FF/VI (95 percent confidence interval, 0.67 to 1.16; P = 0.387). Lower rates of cardiovascular and respiratory death as well as death associated with the patient’s COPD were confirmed by independent adjudication.

“In this secondary analysis of an efficacy outcome from the IMPACT trial, once-daily single-inhaler FF/UMEC/VI triple therapy reduced the risk of ACM versus UMEC/VI in patients with symptomatic COPD and a history of exacerbations,” the authors write.

Several authors disclosed financial ties to GlaxoSmithKline, which funded the study.

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