A new triple therapy inhaler is available for the maintenance treatment of chronic obstructive pulmonary disease (COPD). Trimbow® contains the inhaled corticosteroid (ICS), beclometasone, the long-acting beta2 agonist (LABA), formoterol, and the long-acting muscarinic antagonist (LAMA), glycopyrronium.
The efficacy of this combination in a single inhaler was compared to beclometasone plus formoterol in a large double-blind trial. Patients randomised to receive triple therapy demonstrated a 23% reduction in exacerbations compared to dual therapy.
Trimbow® is now available on the PBS as a streamlined authority item. The clinical criteria is for patients who have experienced at least one severe exacerbation, or multiple moderate exacerbations, of COPD in the previous 12 months despite regular bronchodilator therapy. Patients must also have been stabilised on a combination of a LAMA, LABA, and an ICS.
The Trimbow® inhaler must be refrigerated prior to dispensing to the patient. However, patients may keep the inhaler below 30°C for up to two months. Patients should be advised to rinse their mouth after use to reduce the risk of oropharyngeal candida infections.
- Singh D, Papi A, Corradi M, Pavlišová I, Montagna I, Francisco C, et al. Single inhaler triple therapy versus inhaled corticosteroid plus long-acting β2-agonist therapy for chronic obstructive pulmonary disease (TRILOGY): a double-blind, parallel group, randomised controlled trial. Lancet. 2016; 388(10048): 963-73.
- Trimbow® (beclometasone dipropionate, formoterol (eformoterol) fumarate dihydrate and glycopyrronium bromide (glycopyrrolate) Australian approved product information. Hawthorn East: Chiesi Australia. Approved February 2021.