A Pooled Analysis of Mortality in Patients with COPD Receiving Triple Therapy versus Dual Bronchodilation

Abstract

Introduction : A possible mortality benefit of long-acting muscarinic antagonist (LAMA)/long-acting β2-agonist (LABA)/inhaled corticosteroid (ICS) versus LAMA+LABA combination treatment is reported in patients with highly symptomatic chronic obstructive pulmonary disease (COPD) with a history of exacerbations (≥1 moderate/severe exacerbation in previous year). We compared the time to all-cause mortality with LAMA+LABA+ICS versus LAMA+LABA in patients with moderate-to-severe COPD and predominantly lower exacerbation risk. Methods : Patients who received either LAMA+LABA+ICS (n=11,891) or LAMA+LABA (n=3,156) were pooled from phase 3/4 randomized controlled trials (TONADO 1/2, DYNAGITO, WISDOM, UPLIFT and TIOSPIR). Analysis was on-treatment and censored at 52 weeks. Propensity score (PS)-matched cohorts (covariates: age, sex, Conclusions : This pooled analysis showed no differences in mortality between LAMA+LABA and LAMA+LABA+ICS in patients with moderate-to-severe COPD and predominantly lower exacerbation risk.