The following is a summary of “Effects of triple therapy on disease burden in patients of GOLD groups C and D: results from the observational COPD cohort COSYCONET,” published in the March 2024 issue of Pulmonology by Zader et al.

Chronic obstructive pulmonary disease (COPD) management often necessitates complex therapeutic approaches to mitigate exacerbation risk and improve patient outcomes. While randomized controlled trials have underscored the benefits of inhaled triple therapy (combining LABA/LAMA/ICS) in COPD patients at high risk of exacerbations, the translation of these findings to real-world clinical settings remains a critical area of investigation. 

In this retrospective observational study, researchers sought to evaluate whether the favorable effects observed in controlled trials persist under continuous treatment in routine clinical practice. Leveraging data from the COSYCONET COPD cohort, encompassing baseline and 18-month follow-up assessments, the study group focused on patients classified as GOLD groups C/D at both time points (n = 258). Patients were stratified into two groups: those consistently receiving triple therapy (triple always, TA) and those not consistently receiving triple therapy (triple not always, TNA). Investigators rigorously adjusted for baseline differences between groups regarding therapy predictors and outcomes by employing multiple regression analysis, propensity score matching, and inverse probability weighting. 

Initially, TA patients exhibited significant impairments in lung function, quality of life, and symptom burden compared to their TNA counterparts. However, most of these differences became nonsignificant following meticulous adjustment for confounding variables. While total direct healthcare costs remained elevated in both groups, TA patients experienced reduced inpatient costs, with minimal changes observed in medication-related expenses. The findings suggest that long-term triple therapy may confer beneficial effects in COPD management, albeit with limitations inherent in observational studies, including variances in patient characteristics and treatment modalities. This study underscores the importance of further research to elucidate the optimal therapeutic strategies for COPD patients in real-world clinical settings.

Source: bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-024-02902-4