Triple therapy with Fluticasone furoate/Umeclidinium/Vilanterol compared with dual bronchodilation or triple therapy with inhaled corticosteroids/dual bronchodilation in patients with chronic obstructive pulmonary disease

Background and Aims: Previous study showed triple therapy with Fluticasone furoate/Umeclidinium /Vilanterol(FF/UME/VI) reduced exacerbations versus dual therapies. However, treatment response to inhaled corticosteroids(ICS) is unstable in patients with chronic obstructive pulmonary disease(COPD). We aimed to know the efficacy of ICS to lung function in triple therapy. Methods: Patients (n=104) with COPD were medicated by two or three therapies sequentially. These therapies are with FF/UME/VI or dual bronchodilation(:Umeclidinium/Vilanterol(UME/VI), Glycopyrronium /Indacaterol(GLY/IND), Tiotropium/Olodaterol(TIO/OLO)) or triple therapy consisting in ICS/dual bronchodilation in each device. In every therapy, we measured lung function(FEV1, IC) and COPD assessment test(CAT) score for comparison. Results and Conclusions: CAT score with FF/UME/VI(14.1±8.0 vs 16.1±8.3(p=0.36)) or dual bronchodilation (11.8±6.0 vs 16.1±8.3(p=0.02)) was lower than with another triple therapy. FF/UME/VI had a tendency to improve FEV1 more than dual bronchodilation(1.73±0.60 vs 1.70±0.56(p=0.19)) or another triple thrapy(1.40±0.63 vs 1.38±0.65(p=0.25)). In contrast, IC was inclined to decrease with FF/UME/VI compared with dual bronchodilation(2.03±0.57 vs 2.04±0.56(p=0.69)) or another triple therapy (1.94±0.64 vs 2.00±0.65(p=0.08)) . ICS of triple therapy in one device may be contributable to improvement of air way obstruction, but may not effect on inspiratory capacity.