2016 annual congress of the European Respiratory Society

Triple therapy with beclometasone, formoterol, and glycopyrronium was superior to treatment with tiotropium for the primary outcome of COPD exacerbation rate in a phase 3, double-blind study (TRINITY). In this study, 2691 patients with severe COPD were randomly assigned to receive one of the following: combined fixed-dose triple therapy with beclometasone, formoterol, and glycopyrronium; tiotropium only; or beclometasone, formoterol, and tiotropium given individually. All treatments were given for 52 weeks. The rate of COPD exacerbations was reduced by 20% in the fixed-dose triple therapy group compared with the tiotropium-only group (p=0·003). The secondary outcome of pre-dose FEV1 was also significantly improved in the triple-therapy group compared with the tiotropium-only group by 0·061 L (95% CI 0·037–0·086; p<0·001). The combination of beclometasone, formoterol, and tiotropium had a similar effect on reduction of moderate to severe exacerbations as the fixed-dose triple therapy. Jørgen Vestbo (University of Manchester, Manchester, UK), one of the study authors commented “The TRINITY trial quite clearly shows that for exacerbation prevention, triple therapy with a combined inhaler is more efficacious than tiotropium alone.” Efficacy and safety of RPL554, a dual PDE3 and PDE4 inhibitor, in healthy volunteers and in patients with asthma or chronic obstructive pulmonary disease: findings from four clinical trialsIn four exploratory studies, inhaled RPL554 is an effective and well tolerated bronchodilator, bronchoprotector, and anti-inflammatory drug and further studies will establish the full potential of this new drug for the treatment of patients with COPD or asthma. Full-Text PDF