![]() The EVELUT ® study compared the effectiveness of these two treatment strategies, evaluating the switch to fixed-dose LAMA/LABA (tiotropium/olodaterol Spiolto Respimat ®) versus any triple therapy (fixed or free) in terms of symptom relief and health status improvement, in patients on LABA/ICS without frequent or severe exacerbations who continued to experience symptoms (GOLD B) Previously, GOLD had included escalation to triple therapy (LAMA/LABA/ICS) as an alternative follow-up option for this group of patients. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) no longer recommends a long-acting β 2-agonist (LABA) plus inhaled corticosteroid (ICS) combination for the treatment of COPD, recommending that symptomatic patients at low exacerbation risk be switched from LABA/ICS to long-acting muscarinic antagonist (LAMA)/LABA. Switching from LABA/ICS to LAMA/LABA can provide symptom relief and improve health status without exposure to the risks associated with ICS. In patients with symptomatic COPD at low exacerbation risk, treatment can be switched from LABA/ICS to LAMA/LABA without compromising clinical benefit, compared with escalating to LAMA/LABA/ICS. Marginally more patients on Tio/Olo responded to treatment versus TT (Δ mMRC score ≥ 1 25% vs. In both groups, Physician’s Global Evaluation scores increased, with 69–89% of patients satisfied with their treatment overall. In a propensity score-matched set (Tio/Olo, n = 121 TT, n = 121), improvement in mMRC score was similar in patients on Tio/Olo (–0.23 95% confidence interval –0.11, –0.36) and TT (–0.25 95% CI –0.13, –0.38). The safety set contained 463 patients (Tio/Olo, n = 329 TT, n = 134). Primary endpoints were change in modified Medical Research Council (mMRC) and COPD Assessment Test™ (CAT™) scores after 12 weeks. Patients with symptomatic COPD at low exacerbation risk (GOLD B) were switched, at their physicians’ discretion, from LABA/ICS to either fixed-dose LAMA/LABA (tiotropium/olodaterol, Respimat ® ) or fixed or free TT. EVELUT ®, a real-life, observational study, compared these two treatment strategies in terms of symptom relief and health status improvement. In patients treated with LABA/ICS, who continue to experience symptoms without frequent or severe exacerbations, GOLD now recommends switching to long-acting muscarinic antagonist (LAMA)/LABA instead of escalating to triple therapy (TT LAMA/LABA/ICS), which previously was also a recommended option. ![]() ![]() The Global Initiative for Chronic Obstructive Lung Disease (GOLD 2023) no longer recommends a long-acting β 2-agonist (LABA) plus inhaled corticosteroid (ICS) combination for the treatment of chronic obstructive pulmonary disease (COPD).
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