PT - JOURNAL ARTICLE AU - Ohtsuka, Kengo AU - Harada, Naoko AU - Horiuchi, Atsuo AU - Umemoto, Shintaro AU - Kurabatashi, Ryo AU - Yui, Akie AU - Yamamura, Hiroyuki AU - Shinka, Yoko AU - Miyao, Naoki TI - Therapeutic Response to Single-Inhaler Triple Therapies in Moderate-to-Severe COPD AID - 10.4187/respcare.10188 DP - 2023 Mar 01 TA - Respiratory Care PG - 330--337 VI - 68 IP - 3 4099 - http://rc.rcjournal.com/content/68/3/330.short 4100 - http://rc.rcjournal.com/content/68/3/330.full AB - BACKGROUND: COPD is characterized by progressive and irreversible air flow limitations. Single-inhaler therapies (SITTs) incorporating an inhaled corticosteroid, a long-acting muscarinic antagonist, and a long-acting β2-agonist have been shown to effectively alleviate symptoms and improve lung function. Fluticasone-furoate/umeclidinium/vilanterol (F/U/V) and budesonide/glycopyrronium/formoterol (B/G/F) are available as SITT in Japan. However, the clinical differences between these 2 combinations and the predictors of their proper use have not been established. This study aimed to identify the subject characteristics that could predict the effectiveness of inhaler therapy.METHODS: We assessed the pulmonary function test results of subjects with COPD before and one month after using F/U/V and B/G/F as SITT. Subjects with a difference of 100 mL or more in the FEV1 after treatment with pre-SITT were extracted and divided into the F/U/V effect and no-effect group and B/G/F effect and no-effect group to examine the factors associated with positive outcomes with each inhaler.RESULTS: F/U/V and B/G/F significantly improved the inspiratory capacity (IC), %IC, FVC, and %FEV1 when compared to pre-intervention values (P < .001, P = .001, P = .007, P = .009, respectively, for F/U/V; and P = .006, P = .008, P = .038, P = .005, respectively, for B/G/F). Factors associated with FEV1 improvement in F/U/V included lower %IC (odds ratio 0.97 [95% CI 0.94–0.99], P = .03) and a higher modified Medical Research Council (mMRC) dyspnea score (2.36 [1.27–4.70], P < .01). In addition, a higher %IC (1.03 [1.00–1.06], P = .02) and lower mMRC dyspnea score (0.55 [0.28–0.99], P = .041) were predictors for the effectiveness of B/G/F.CONCLUSIONS: Our results showed that SITT significantly improved the IC, %IC, FVC, and %FEV1 when compared to pre-intervention and that F/U/V was more effective in subjects with severe symptoms, whereas B/G/F was more effective in subjects with mild symptoms.