An investigational LABA/LABA/ICS “triple” combo therapy tested by University of Manchester researchers resulted in 20% fewer COPD exacerbations, according to a study published in The Lancet.

Researchers compared treatment with extrafine beclometasone dipropionate, formoterol fumarate, and glycopyrronium bromide (BDP/FF/GB; fixed triple) with tiotropium, and BDP/FF plus tiotropium (open triple).

The study involved 2,691 patients over a one-year period. After a 2-week run-in period receiving one inhalation per day via single-dose dry-powder inhaler of open-label 18 ?g tiotropium, patients were randomised (2:2:1) using a interactive response technology system to 52 weeks treatment with tiotropium, fixed triple, or open triple.

Moderate-to-severe exacerbation rates were 0.46 for fixed triple, 0.57 for tiotropium, and 0.45 for open triple. For week 52 pre-dose FEV1, fixed triple was superior to tiotropium and non-inferior to open triple.

“In our … study, treatment with extrafine fixed triple therapy had clinical benefits compared with tiotropium in patients with symptomatic COPD, FEV1 of less than 50%, and a history of exacerbations.”