Effectiveness of Triple Drug Fixed Dose Combination Inhaled Therapy in Severe COPD Patients

摘要

Rationale: According to GOLD 2018 guidelines, inhaled corticosteroids are recommended along with long acting muscarinic antagonist (LAMA) and long acting beta-2 agonist (LABA) inhaler medications in Group D COPD patients who show frequent exacerbations and symptom severity. Therefore, the use of triple drug inhaled medication in such severe COPD patients become necessary. Objectives: To know the effectiveness of inhaled triple drug medication in relation to spirometry, exercise tolerance, symptom control and prevention of exacerbations in severe COPD patients. Method: 25 severe COPD patients were included in this hospital based study. Before initiating the triple drug inhaled medication the baseline parameters such as spirometry ( FEV1), exercise tolerance (6 minute walking distance) and symptom control(CAT score, MMRC dyspnoea grading) are measured. 2 monthly follow-up till 6months of the study period is done. At each visit all the baseline parameters are reassessed. Result: There is statistically significant (p=0.01) improvement in the FEV1, CAT scoring, MMRC grad-ing, 6 Minute Walking Distance in the 25 subjects following initiation of treatment with the triple drug in-haler medication over 6months observation period. Conclusion: Triple drug inhaler medication in severe COPD patients is effective in improving airflow ob-struction, symptom control, exercise tolerance and prevention of exacerbations.