Abstract

Chronic obstructive pulmonary disease (COPD) refers to a variety of lung conditions that are characterized by persistent, frequently progressive airflow obstruction and chronic respiratory symptoms (dyspnoea, cough, sputum production, exacerbation). COPD patients with persistent dyspnoea are at higher risk of exacerbation in which triple drug inhaled therapy is suggested. Earlier patients who used open triple drug therapy needed at least two inhalers more than once daily. The significance of ICS in the treatment paradigm of patients with severe COPD and recurrent exacerbations has lately been called into question. Our study was conducted to compare acute exacerbation and all-cause mortality among patients who used triple drug regimen via single inhaler and multiple inhalers.
Materials and Methods: The present study was a hospital based prospective cohort study. This study was conducted from February 2021 to March 2022 at the Department of Respiratory Medicine, Mahatma Gandhi medical college & hospital. Eligible patients were aged more than 18 years and FEV1 <50%. Acute exacerbations were observed over the period of 3 months by prescribing single inhaler triple therapy (SITT) or multiple inhaler triple therapy (MITT) according to the symptoms and severity of COPD.
Result: Overall, 60 patients were taken into study cohort. On follow up of 3 months baseline characteristics between the cohorts were comparable. Single inhaler triple therapy was associated with a lower risk of COPD exacerbations compared with multiple inhaler triple therapy. Single inhaler triple therapy led to a more significant improvement in lung symptoms and quality of life compared with multiple inhalers triple therapy.
Conclusion: In this study, triple therapy with single inhaler resulted in fewer moderate or severe COPD exacerbations than patients who used multiple inhalers. In addition, triple therapy single inhaler resulted in a reduced rate of COPD hospitalisation as well as improved lung symptoms and quality of life.