RT Journal Article
T1 A Delphi Consensus Document on the Use of Single-Inhaler Fixed-Dose Triple Therapies in COPD Patients.
A1 Lopez-Campos, Jose Luis
A1 Alcazar-Navarrete, Bernardino
A1 Riesco-Miranda, Juan Antonio
A1 Cosio, Borja G
A1 de-Torres, Juan P
A1 Celli, Bartolome
A1 Jimenez-Ruiz, Carlos A
A1 Casanova-Macario, Ciro
K1 Delphi consensus
K1 LABA/ICS
K1 LABA/LAMA
K1 bronchodilator agents
K1 chronic obstructive pulmonary disease
K1 inhaled corticosteroids
K1 statements
K1 triple therapy
AB Despite the evidence provided by clinical trials, there are some uncertainties and controversies regarding the use of triple inhaled therapy. With the aim of evaluating clinical practice in specialized respiratory units, a Delphi consensus document was implemented on the use of single-inhaler fixed-dose triple therapies after 1 year of use in Spain. A scientific committee of COPD experts defined a thematic index, guided a systematic literature review and helped design the Delphi questionnaire. This was sent to the other 45 COPD experts between April and June 2019. Agreement/disagreement on 58 statements was tested in two rounds using a Likert scale. Replies were classified as a consensus when ≥80% of the panelists agreed; a majority when a degree of agreement of ≥66% was reached; and divergence if agreement was  After two rounds, 44.44% of the statements reached consensus, 14.81% reached majority and 40.74% were divergent. Panelists agreed that escalating from double bronchodilation should be phenotype-based and aim to prevent exacerbations but not for improving symptoms. The addition of an antimuscarinic to inhaled corticosteroids combinations achieves improvement in lung function, symptoms and exacerbation prevention. Main safety concerns included the increased risk of pneumonia as compared to bronchodilator therapies, with similar cardiovascular effects. There was no consensus agreement on patient type response based on blood eosinophil counts or obstruction severity. The low degree of consensus among panelists may reflect the complexity of severe COPD management. The information provided here may be useful to clinicians implementing personalized medicine for COPD patients.
PB Dove Medical Press Ltd.
YR 2020
FD 2020-07-27
LK http://hdl.handle.net/10668/16204
UL http://hdl.handle.net/10668/16204
LA en
NO López-Campos JL, Alcázar Navarrete B, Riesco Miranda JA, Cosío BG, de-Torres JP, Celli B, et al. A Delphi Consensus Document on the Use of Single-Inhaler Fixed-Dose Triple Therapies in COPD Patients. Int J Chron Obstruct Pulmon Dis. 2020 Jul 27;15:1801-1811.
DS RISalud
RD Apr 20, 2025