Triple therapy inhaler improves lung hyperinflation, exercise endurance time in COPD
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Key takeaways:
- Compared with a dual therapy inhaler, a triple therapy inhaler improved inspiratory capacity in those with COPD.
- Patients’ exercise endurance time improved with both inhalers.
SAN DIEGO — An inhaler with beclomethasone dipropionate, formoterol fumarate and glycopyrronium lowered lung hyperinflation in patients with COPD, according to research presented at the American Thoracic Society International Conference.
Further, this triple therapy inhaler, along with a dual therapy inhaler including beclomethasone dipropionate and formoterol fumarate, benefitted patients by improving exercise endurance time, according to researchers.
In a randomized, double-blind, three-period crossover, placebo-controlled phase 4 study, Henrik Watz, MD, co-leader of the Pulmonary Research Institute at LungenClinic Grosshansdorf, Airway Research Center North and member of the German Center for Lung Research, and colleagues assessed 106 patients (38% women) with symptomatic moderate to severe COPD to see how a single inhaler triple therapy, a single inhaler dual therapy and placebo each impact lung hyperinflation and exercise endurance time after 3 weeks of use.
Researchers noted that included patients had hyperinflation while receiving stable mono or dual inhaled maintenance COPD treatment.
The triple therapy was composed of 100 μg extra-fine beclomethasone dipropionate per actuation, 6 μg formoterol fumarate per actuation and 10 μg glycopyrronium per actuation (BDP/FF/G; Chiesi), whereas the dual therapy only included 100 μg BDP per actuation and 6 μg FF per actuation (BPD/FF).
For all three treatments, the administration regimen was two inhalations twice a day.
Between baseline and the end of the 3-week treatment period, researchers observed a significantly greater change in 2-hour post-dose inspiratory capacity with BDP/FF/G vs. placebo (0.315 L; 95% CI, 0.25-0.38; P < .001), as well as with BDP/FF vs. placebo (0.223 L; 95% CI, 0.16-0.285; P < .001).
Additionally, compared with placebo, the change in 2-hour post-dose exercise endurance time from baseline was better with the triple therapy (69.2 seconds; 95% CI, 32.9-105.5; P < .001) and the dual therapy (70.1 seconds; 95% CI, 33.6-106.6; P < .001).
In terms of changes in inspiratory capacity at isotime, which was defined as the “shortest [exercise endurance time] at either the start or end of each treatment period” from baseline, significant improvement was found with BDP/FF/G vs. placebo (0.245 L; 95% CI, 0.147-0.342; P < .001) but not with the dual therapy inhaler vs. placebo.
Between the triple therapy inhaler and the dual therapy inhaler, researchers noted that BDP/FF/G improved inspiratory capacity 2-hour post-dose (0.092 L; 95% CI, 0.028-0.157; P = .005) and inspiratory capacity at isotime (0.149 L; 95% CI, 0.052-0.246; P = .003).
With no reported safety signals from the researchers, the inhalers appear safe.