Triple therapy refers to a new combined treatment regimen for chronic obstructive pulmonary disease (COPD). It involves taking three medications simultaneously:
- an inhaled corticosteroid
- a long-acting beta2-agonist (LABA)
- a long-acting muscarinic antagonist (LAMA)
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommends triple therapy for patients who have recurrent exacerbations, or flare-ups of respiratory symptoms.
This treatment is recommended despite initial treatment with a dual bronchodilator or LABA/corticosteroid combination.
Improvements in lung function and quality of life have been observed in patients receiving triple inhalation therapy for COPD compared with dual inhalation therapy or monotherapy.
Newer inhalers now provide all three of these medications in a single inhaler.
Prior to triple therapy, the GOLD guidelines had emphasized the use of dual therapy, or combination LABA and LAMA bronchodilators, for patients with COPD who had persistent shortness of breath or frequent exacerbations despite monotherapy.
There are several fixed-dose LABA/LAMA combination inhalers available, which are currently the principal therapy for many patients with COPD.
Some symptomatic and quality of life aspects have been shown to improve with triple therapy compared to dual therapy.
But no improvement in survival has been seen with triple therapy. More research must be done to better understand the risk and benefit between these two types of combination therapies.
Stem cells have the unique ability to change into any cell in the body, which is called differentiation.
They can be administered locally, which allows them to differentiate into nearby tissue so they can regenerate and repair damaged tissue around organs.
The thought for patients with COPD is that stem cells can repair damaged lung tissue to combat emphysema or chronic bronchitis.
However, the studies that used stem cells in patients with moderate to severe COPD did not lead to clear improvements in respiratory function. There’s a lot that’s not yet known about stem cell types and how they work.
The best natural forms of therapy are things that can help improve our overall health and will naturally help speed up the process of recovery.
For COPD, the single most important thing you can do is to quit smoking.
Exercising and eating right are also very important to maintain a healthy body weight. You must also get adequate rest and a good night’s sleep.
Yes. Combination bronchodilators are the mainstay therapy for many patients with symptomatic COPD. They are more effective than monotherapies for improving symptoms and quality of life.
Unfortunately, cost will always be a factor, especially based upon:
- medication availability
- socioeconomic status
- type of insurance you have
Inhaled medications can cost COPD patients several hundred dollars per year despite having health insurance.
Utilizing combined therapies in a single inhaler provides a cost-effective treatment option while improving medication compliance for patients with symptomatic COPD and a history of exacerbations.
As more of these combination inhalers become available, we hope to see the price of these medications come down.
This will allow them to be affordable for all patients, so they can properly manage their condition and stay out of the hospital.
Dr. Dasgupta completed his internal medicine residency at Michigan State University, his pulmonary/critical care fellowship at Columbia University Saint and Luke’s Roosevelt Hospital, and his sleep medicine fellowship at Henry Ford Hospital. During his training, he received numerous awards, including resident of the year, fellow of the year, and the director’s award for research. He’s currently an assistant professor at the University of Southern California where he’s received the faculty teaching award for the last 6 consecutive years. He is quadruple board certified in internal medicine, pulmonary, critical care, and sleep medicine. He currently teaches all three steps for the United States Medical Licensing Examination and has taught Internal Medicine Board Review around the world for the past 18 years. His first book in a series titled “Medicine Morning Report: Beyond the Pearls” was published in 2016 by Elsevier. He also appears on various media platforms and television shows, such as “Chasing The Cure,” “The Doctors,” CNN, and “Inside Edition.” For more information, visit rajdasgupta.com and beyondthepearls.net.