An inhaler is a method of administering medication for COPD. You only need to breathe into the L-shaped gadget for it to transport the drug to your lungs.
Separate inhalers may be used for each medication. Alternatively, you may combine many medicines into a single inhalation.
What Is Triple Therapy?
To treat COPD, the triple treatment uses three inhalants:
- a corticosteroid to bring down the swelling in your airways
- a long-acting beta-agonist to relax the muscles around your airway
- an anticholinergic drug to widen the large airways
Triple treatment was formerly administered by two different inhalers. Both a long-acting beta-agonist and an inhaled corticosteroid were packaged into a single inhaler. The anticholinergic substance was hidden in the other.
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Trelegy Ellipta is the first inhaler to combine three treatments into one, and the FDA authorized it in 2017. Specifically, it combines:
- fluticasone furoate, a corticosteroid
- vilanterol, a long-acting beta-agonist
- umeclidinium, an anticholinergic
Trelegy Ellipta is a once-daily powdered drug that is inhaled by an inhaler. This drug helps you breathe better for a whole day by widening your airway, decreasing lung edema, and relaxing your respiratory muscles.
If your COPD symptoms are not under control and you keep having flare-ups, your doctor may prescribe triple treatment.
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What Is Dual Therapy?
The inhaler used in dual treatment for chronic obstructive pulmonary disease contains two different medications. Since 2013, patients have had access to this therapy.
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In some instances, doctors may prescribe a combination of an anticholinergic and a long-acting beta-agonist.:
- Anoro Ellipta (umeclidinium and vilanterol)
- Duaklir (aclidinium bromide and formoterol fumarate)
Another combines a long-acting beta-agonist with a corticosteroid:
- Breo Ellipta (fluticasone furoate and vilanterol)
Does Triple Work Better Than Dual?
It seems that triple treatment is superior to dual therapy in reducing flares and improving the quality of life in people with COPD.
However, this may cause a more significant occurrence of adverse effects. Research shows that people on triple medication for COPD had fewer flare-ups than those on dual therapy. Additionally, they had a lower risk of being admitted to the hospital due to an episode of COPD symptoms.
Triple treatment was associated with fewer moderate-to-severe COPD flares, greater lung function, and an enhanced quality of life compared to dual therapy, according to a meta-analysis of 21 trials.
Triple treatment has the drawback of increasing the risk of pneumonia. It seems that administering all three medications in a single inhaler is not more effective than helping them separately.
The primary benefit of taking all three medications simultaneously is the time savings associated with doing so. If medication dosage is simplified, patients are more likely to continue taking it as directed.
Moreover, it has been suggested that the efficacy of treating COPD with a combination of three medications with diverse mechanisms of action might be increased. The evidence for such, however, is lacking.
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Who Is Eligible?
Those who suffer from chronic obstructive pulmonary disease (COPD), such as those who have chronic bronchitis or emphysema, may take Trelegy Ellipta. If your doctor notices that your condition has not improved after two different treatments, they may decide to give this medication. People with asthma should not use Trelegy Ellipta.
The maintenance therapy of COPD may now include dual treatments like Anoro Ellipta and Duaklir. The FDA has also authorized Breo Ellipta for the treatment of adult asthma.
Side Effects
The most often seen adverse effects of triple treatment include:
- headache
- back pain
- a change in your sense of taste
- diarrhea
- cough
- throat pain
- stomach flu
Possible further side effects include:
- increased chance of getting pneumonia
- yeast infection of the mouth
- worsening of existing conditions such as tuberculosis
- weakened bones
- glaucoma and cataract
Boxed warnings indicating the increased mortality risk from long-acting beta-agonists like vilanterol in people with asthma may be seen on the packaging for medications including Trelegy Ellipta, Anoro Ellipta, and Duaklir. People with asthma should avoid using these medications.
