BDP/FF/GB single-inhaler triple therapy in COPD: real-world effectiveness, safety, and adherence in a pooled analysis of 5,000 patients

BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) represents a major global health challenge, frequently necessitating triple therapy for patients unresponsive to dual bronchodilation. Single-inhaler triple therapy (SITT) combining beclomethasone dipropionate/formoterol fumarate/glycopyrronium bromide (BDP/FF/GB) offers a practical and effective solution with potential adherence benefits in real-world settings. METHODS: ), and adherence, with safety and exacerbation rates assessed through 12 months. Subgroup comparisons based on prior therapy, exacerbation history, and disease severity were also performed. RESULTS: improvements were observed up to 6 months, with over 40% of patients achieving ≥100 mL increase. Adherence significantly improved, with poor-adherence patients transitioning to higher categories over time. Logistic regression identified poor baseline adherence (vs. good), ex-smokers (vs non-smokers), and experiencing two (vs. >2) exacerbations as predictors of treatment response. Adverse events were reported by 21.9% of patients. CONCLUSION: Extrafine BDP/FF/GB SITT demonstrated significant real-world safety and effectiveness in improving symptoms, lung function, and adherence.