Abstract :
Introduction: Triple therapy (Long Acting Muscarinic Antagonist (LAMA), Long Acting b 2 Agonist
(LABA), Inhaled Corticosteroid (ICS)) for Chronic Obstructive Pulmonary Disease (COPD) is available as
single or separate inhalers. There is a dearth of studies in real-world scenario comparing them.
Materials and Methods: We followed up 33 moderate to severe COPD patients each on single inhaler
(Tiotropium-Formoterol-Ciclesonide) and two separate inhalers (Tiotropium; Formoterol-Budesonide) for
triple therapy for a period of three months.We compared socio-demography, Test of Adherence to Inhalers
(TAI) score, baseline and improvement in FEV1, FEV1/FEV, St George Respiratory Questionnaire score
(SGRQ) and Euro Qol 5 Dimension Scale score (EQ-5D) by independent t-test or Mann Whitney U test.
The change in each group was compared with their baseline by paired t-test or Wilcoxon Signed Rank test.
Results: The groups were comparable at the baseline with respect to age, gender, smoking, FEV1/FEV,
SGRQ, EQ-5D; TAI but, separate inhaler group was worser than single inhaler group with respect to
baseline FEV1 (Severe COPD - 61% Vs. 30%) and spacer use (70% Vs. 100%) (p
improved significantly on FEV1, FEV1/FEV, SGRQ and EQ-5D (p
separate inhalers was significantly (p
5% Vs. 1%), FEV1/FEV (median 0.04 Vs. 0.02), SGRQ (mean -50.1 Vs. -25.5) and EQ-5D (median -3 Vs.
-1).
Conclusion: Triple therapy improves patients by single or separate inhalers. Patients on separate inhalers
had more improvement than patients on single inhaler without considering the confounding factors.
Keyword :
COPD, Inhalers.