June #pulmCC Twitter Chat: Role of Triple Therapy in Management of COPD

Led by Viren Kaul, MD, and Nancy Stewart, MD

June 14, 2018

Join us Wednesday, June 27 at 7 pm Central/8 pm Eastern as we discuss another hot topic in pulmonary, critical care, and sleep medicine. The topic? Triple therapy in COPD!

COPD is the third-highest cause of death in the United States and is responsible for 120,000 deaths every year! Triple therapy (ie, a combination of inhaled corticosteroids, long-acting beta agonists, and long-acting muscarinic antagonists) is recommended primarily for more severely ill patients (Global Initiative for Chronic Obstructive Lung Disease group D). This therapy can potentially prevent decline of lung function, improve symptoms, and prevent acute exacerbations. However there are risks, primarily an increased risk of pneumonia that must be considered before starting a patient on triple therapy.

Recently, the results of newly released clinical trials and changes in the landscape of medications may have changed providers’ understanding of the risks and benefits of inhaled therapies for COPD. In this #pulmcc Twitter chat, we will discuss triple therapy in COPD along with pulmonologist Dr. Sucharita Kher (@sucharitakher) and CHEST faculty Viren Kaul (@virenkaul) and Nancy Stewart (@nvhs0401).  Please join us!

Topics:

T1: When do you currently use triple therapy in the treatment of COPD?

T2: Why did the IMPACT trial show reduction in COPD exacerbations when other previous trials (eg, FLAME) did not?

T3: Based on the study, how concerned are you about the risk of pneumonia due to inhaled corticosteroids?

T4: How will the results of the IMPACT trial affect your use of triple therapy in COPD? Should it be considered in other COPD group patients?

We are offering CME credit for participation in this Twitter chat! For additional information on eligibility and how to claim, learn more here. NOTE: To receive CME credit, you must complete the survey in the learning site within three (3) days after the Twitter chat.

CHEST members, if you’ve joined a CHEST Twitter chat, you are eligible to receive participation points for each chat you’ve participated in. Claim them here. 

References

1. Lipson, DA, et al. Once-daily single-inhaler triple versus dual therapy in patients with COPD. N Engl J Med. 2018;378(18):1671-1680. https://www.nejm.org/doi/full/10.1056/NEJMoa1713901

2. Lipson, DA, et al. FULFIL trial: once-daily triple therapy for patients with chronic obstructive pulmonary disease. Am Respir Crit Care Med. 2017;196(4): 438-446. https://www.atsjournals.org/doi/abs/10.1164/rccm.201703-0449OC

3. Wedzicha, JA, et al. Indacaterol–glycopyrronium versus salmeterol–fluticasone for COPD. N Engl J Med. 2016; 374(23): 2222-2234. https://www.nejm.org/doi/full/10.1056/NEJMoa1516385 

   4.  Calverley, PMA, et al. Triple Therapy in COPD: What We Know and What We Don't. COPD: Journal of Chronic Obstructive Pulmonary Disease 2017;14(6):648-662. https://www.tandfonline.com/doi/abs/10.1080/15412555.2017.1389875