Daily Dose: Delay Before Start of Triple Therapy Raises Risk for COPD Exacerbations

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.


On October 21, 2022, we reviewed a study presented at the American College of Chest Physicians (CHEST) 2022 Annual Meeting, that assessed whether prompt initiation of triple therapy (TT) following a second moderate exacerbation within 12 months was associated with a lower risk of subsequent COPD exacerbations.

The study

There were 17 988 adults aged ≥40 years with a diagnosis of COPD included in the study. Patients were stratified into 3 groups based on timing of a TT prescription after the index exacerbation:

  • Prompt within 30 days (25.6%)

  • Delayed 31-180 days (42.7%)

  • Very delayed 181+ days (31.7%)

The results

Proportion of patients who had ≥1 exacerbations by length of TT initiation delay:

  • Prompt: 66.6%

  • Delayed: 81.3%

  • Very delayed: 88.5% (p<.01)

Clinical implications

"Delays in starting triple therapy may introduce avoidable risks of future exacerbations including hospitalizations. These results support a more proactive approach to the management of COPD following moderate exacerbation events, particularly initiation of triple therapy," concluded researchers.

Click here for the full study review.