A single-inhaler triple therapy combining beclometasone dipropionate, formoterol fumarate and glycopyrronium helps achieve clinical remission in moderate-to-severe asthma, potentially reducing the need for expensive biologic treatments.
- 26.1% of patients with uncontrolled moderate-to-severe asthma achieved clinical remission after one year of triple therapy treatment
- Triple therapy consisted of beclometasone dipropionate, formoterol fumarate and glycopyrronium delivered through a single inhaler
- Patients achieving remission at 26 weeks were more likely to maintain better control and require fewer oral corticosteroids
A single-inhaler triple therapy regimen could improve moderate-to-severe asthma control, according to new research. The claim comes from an analysis compiled from two clinical trials and is outlined in the paper, Achieving Clinical Remission in Moderate-to-Severe Asthma Using Inhaled Triple Therapy,” published in ERJ Open Research.
According to the research, 26.1% of patients in the study who had uncontrolled moderate-to-severe asthma achieved clinical remission after one year of triple therapy treatment compared with 29.5% of patients receiving traditional dual therapy. This could delay or reduce the need for costly biologic treatments, researchers noted.
Investigators examined data from the TRIMARAN and TRIGGER phase 3 clinical trials involving 2,291 asthma patients whose disease remained uncontrolled despite treatment with inhaled corticosteroids (ICS) and long-acting beta agonists (LABA). Triple therapy consisted of the drugs beclometasone dipropionate, formoterol fumarate and glycopyrronium (BDP/FF/G).
The study aimed to determine whether patients could achieve what researchers said is increasingly being recognized as a new treatment goal in asthma: clinical remission. For the study, remission was defined as no oral corticosteroid use, no severe exacerbations, sustained asthma control and stable or improved lung function over a 52-week period.
Investigators said the concept of clinical remission has gained momentum in recent years as physicians move beyond controlling symptoms toward achieving longer-term disease stability. Several national asthma guidelines, including those in Germany, Italy, Japan and Spain, have incorporated remission as an aspirational treatment target, they noted.
Although biologic therapies have demonstrated the ability to induce remission in severe asthma, researchers said the new findings suggest that optimizing inhaled treatment may allow many patients to achieve similar outcomes without escalating immediately to biologic drugs. Investigators noted that improved adherence, proper inhaler technique and the addition of a long-acting muscarinic antagonist (LAMA) could substantially improve patient outcomes.
The study also found that patients who achieved remission earlier, at 26 weeks, were more likely to maintain better asthma control, experience fewer exacerbations, require fewer oral corticosteroids and demonstrate improved lung function during the remainder of the study.
Several characteristics associated with a higher likelihood of achieving remission emerged from the study, including shorter disease duration, better baseline asthma control, fewer prior exacerbations and greater lung function reversibility. The results support intervention earlier in the disease course before permanent airway remodeling develops, investigators noted.
Despite the positive results, researchers said the findings are based on post hoc analyses of clinical trial data and require confirmation through prospective, long-term studies. Biomarker data were also limited, they said, and noted that additional real-world evidence is needed to validate the remission framework.
