GLIMPSE study: Impact of Triple Therapy on Lung Function, Health Status and Mortality risk in Patients with Advanced Chronic Obstructive Pulmonary Disease

Abstract

Rationale: Benefits of triple therapy have been verified in COPD patients. However there is confined statistics assessing the potential benefits of triple therapy over dual therapy in COPD patients.

Objectives: To estimate the relative impact of triple therapy on lung function, health status and mortality risk compared with ICS/LABA therapy in symptomatic COPD patients with frequent exacerbations in an Indian clinical population.

Method: The GLIMPSE (Lung Function, Health Status and Mortality Risk Assessment in COPD using Triple Therapy) was as a prospective, parallel design, single centre observational study comparing 24 weeks of triple therapy [twice daily combination of Budesonide-Formoterol (100/6 µg) and once daily Tiotropium (9µg)] with ICS/LABA [twice daily Budesonide-Formoterol (100/6µg)]. The primary outcome was mean change in FEV1% predicted and CAT Total score from baseline at week 24. Secondary Outcomes were variation in dyspnea grade and BODE Total score from baseline.

Results: At week 24 in triple therapy (n=70) and ICS/LABA therapy (n=70), mean difference from baseline in FEV1% predicted were 5.40 (95%CI: 1.29 to 9.50) and 1.90 (95%CI: -1.87 to 5.68) respectively, and mean difference in CAT total score from baseline were -5.10 units (95%CI: -3.49 to -6.71) and -1.80 units (95%CI: -0.052 to -3.548) respectively. In addition, there was a statistically significant reduction in dyspnea grading and BODE score with comparable adverse events in both groups.

Conclusion: Overall, the results favoured Triple therapy over dual therapy in advanced symptomatic COPD patients.