Comparison of COPD patients on single inhaler and two separate inhalers for triple therapy – A short duration prospective cohort study

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Original Article

Author Details : Beena Thomas*, P Sukumaran, Janaki M, Maria Theressa John, Sruthy Mary Abraham

Volume : 5, Issue : 1, Year : 2020

Article Page : 38-42

https://doi.org/10.18231/j.ijirm.2020.008

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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<0> improved significantly on FEV1, FEV1/FEV, SGRQ and EQ-5D (p<0> separate inhalers was significantly (p<0> 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.

Keywords: COPD, Inhalers.

How to cite : Thomas B, Sukumaran P, Janaki M, John M T, Abraham S M, Comparison of COPD patients on single inhaler and two separate inhalers for triple therapy – A short duration prospective cohort study. IP Indian J Immunol Respir Med 2020;5(1):38-42

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