Triple combo outperforms dual therapies in moderate-to-very severe COPD

In the treatment of patients with moderate-to-very severe chronic obstructive pulmonary disorder (COPD), triple treatment with budesonide, glycopyrrolate, and formoterol fumarate (BGF) confers greater improvements in symptoms and health-related quality of life (HRQoL) relative to dual therapies, according to data from the ETHOS trial.

ETHOS included 8,509 patients (mean age 64.7 years, 59.7 percent male, mean COPD Assessment Test score 19.6) who experienced ≥1 moderate/severe exacerbation in the previous year. These patients were randomly assigned to one of the following treatment groups: (1) BGF 320/18/9.6 μg, (2) BGF 160/18/9.6 μg, (3) glycopyrrolate/formoterol fumarate (GFF) 18/9.6 μg, or (4) budesonide/formoterol fumarate (BFF) 320/9.6 μg. Treatment was administered twice daily via single Aerosphere inhaler for 52 weeks.

Over 52 weeks, BGF 320 led to a significant reduction in rescue medication use compared with GFF and BFF (−0.53 puffs/day and −0.35 puffs/day; p<0.0001 and p=0.0002, respectively).

Likewise, BGF 320 produced a meaningful change in St George's Respiratory Questionnaire (SGRQ) total score, with the proportion of SGRQ responders higher than in groups that received dual therapies over 24 weeks (52.5 percent vs 42.5 percent [GFF] and 45.2 percent [BFF]) and 52 weeks (47.0 percent vs 37.8 percent and 41.0 percent).

Results for BGF 160 followed a similar pattern.