Prospective Randomized Study on Switching Triple Inhaler Therapy in COPD from Multiple Inhaler Devices to a Single Inhaler Device in a Chinese Population

Background: Triple therapy with inhaled corticosteroids and dual bronchodilator was recommended in chronic obstructive pulmonary disease (COPD) patients who had exacerbations and eosinophilia. It can be administered by single inhaler (SITT) or multiple inhaler (MITT). There was lack of evidence of the benefits of SITT over MITT in Chinese population, especially on switching from existing MITT to SITT.

Methods: 70 Chinese patients with COPD was recruited in this open-label double-arm clinical trial to investigate the number of critical errors, mMRC dyspnoea scale, MARS-A score and satisfaction score upon switching from MITT to SITT.

Results: The mean number of critical errors were 0.4 ± 1.0 in SITT group and 1.1 ± 1.8 in MITT group, p = 0.038 at first visit; 0.2 ± 0.6 in SITT group and 0.8 ± 1.1 in MITT group, p = 0.007 at second visit. The mean change in MARS-A from baseline to first visit was +3.76 ± 7.48 in SITT group and -1.27 ± 7.76 in MITT group, p-value 0.008. 22 (59.5%) and 8 (24.2%) of the patients in SITT and MITT group had an increase in MARS-A score from baseline to first visit respectively, with adjusted OR (aOR) of 6.23 (95% CI = 1.63 - 23.77, p = 0.007), favoring SITT. There was no significant difference in the change in mMRC dyspnea scale and satisfaction score in the two groups.

Conclusion: Switching from MITT to SITT in Chinese COPD patients may have the benefits of having fewer critical error numbers and higher MARS-A score.