The researchers randomly assigned each patient to a two-in-one inhaler therapy or a triple therapy between 2016 to 2018. In one study, called Trimaran, the triple therapy group was provided one medium dose of the medication, while a simultaneous study, called Trigger, tested the same combo with double the dose of the steroid that is one of the three drugs.
Patients in both studies were able to exhale significantly more air after 26 weeks of receiving the triple therapy. Those in the Trimaran group were able to exhale 185 milliliters more than they could before the treatment, and 57 milliliters more than patients taking just two medications, indicating that their airways were less constricted. Those in the higher dose group were able to exhale 73 milliliters more on average compared to patients taking the dual therapy.
The triple therapy also helped reduce the frequency of asthma attacks, according to the research article. Those in the Trimaran group saw a 15 percent reduction in moderate and severe attacks compared to the standard dual therapy. In the Trigger trial, patients experienced a 12 percent reduction compared to dual therapy, though this difference was not statistically significant.
“The magnitude of results is not jaw-dropping,” said Mohsen Sadatsafavi, who studies respiratory diseases at the University of British Columbia in Vancouver, Canada. But the single inhaler triple therapy is promising for improving patients’ quality of life, which can be harder to measure precisely, he said.
Dr. Sadatsafavi said that it would take time for the treatment to take effect and for any benefits to be recognized by patients.
“It’s like the conversation doctors and patients have when thinking about treating hypertension,” Dr. Sadatsafavi said. “The medication you take might not make you feel better today, but it protects against certain future outcomes that could affect your life forever.”
The Food and Drug Administration would have to approve the new therapy before doctors could prescribe it to patients in the United States. And because both clinical trials only tracked outcomes in adults, almost all of whom were white, the results will need to be extrapolated with caution in children and in the American population in general, said Andrei Constantinescu, a pediatric pulmonologist at Columbia University.