Filling the gaps in COPD: the TRIBUTE study

Chronic obstructive pulmonary disease (COPD) is a major public health problem because of its high prevalence (about 10% of the adult population), rising incidence (COPD is predicted to be the third global cause of death by 2020), and high associated personal, social, and economic costs. 1 Global Initiative for Chronic Obstructive Lung DiseaseGlobal strategy for prevention, diagnosis and management of COPD. http://goldcopd.org/gold-reports/Date: 2018 Google Scholar Regular physical activity, appropriate vaccination, and avoiding toxic exposures (eg, tobacco smoking) are important non-pharmacological approaches for the management of patients with COPD. 1 Global Initiative for Chronic Obstructive Lung DiseaseGlobal strategy for prevention, diagnosis and management of COPD. http://goldcopd.org/gold-reports/Date: 2018 Google Scholar Meanwhile, pharmacological treatment for COPD is fundamentally based on the use of inhaled drugs: long-acting bronchodilators (long-acting antimuscarinic agents, long-acting β2 agonists, or both), with or without inhaled corticosteroids. 1 Global Initiative for Chronic Obstructive Lung DiseaseGlobal strategy for prevention, diagnosis and management of COPD. http://goldcopd.org/gold-reports/Date: 2018 Google Scholar The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommends these drugs be used (alone or in combination) on the basis of the severity of symptoms present and the previous history of COPD exacerbations, a marker of the risk of future exacerbation episodes. 1 Global Initiative for Chronic Obstructive Lung DiseaseGlobal strategy for prevention, diagnosis and management of COPD. http://goldcopd.org/gold-reports/Date: 2018 Google Scholar The GOLD recommendations are based on the best available scientific evidence and, where evidence is absent, on expert opinion. 1 Global Initiative for Chronic Obstructive Lung DiseaseGlobal strategy for prevention, diagnosis and management of COPD. http://goldcopd.org/gold-reports/Date: 2018 Google Scholar Extrafine inhaled triple therapy versus dual bronchodilator therapy in chronic obstructive pulmonary disease (TRIBUTE): a double-blind, parallel group, randomised controlled trialIn patients with symptomatic COPD, severe or very severe airflow limitation, and an exacerbation history despite maintenance therapy, extrafine BDP/FF/G significantly reduced the rate of moderate-to-severe exacerbations compared with IND/GLY, without increasing the risk of pneumonia. Full-Text PDF Department of ErrorAgusti A. Filling the gaps in COPD: the TRIBUTE study. Lancet 2018; 391: 1002–03—In this Comment (published online first on Feb 8, 2018), the first sentence of the fourth paragraph has been corrected to read “First, the incidence of COPD exacerbations was low in both groups of the study.” This correction has been made to the online version as of Feb 14, 2018, and the printed Comment is correct. Full-Text PDF