For a study, researchers sought to look at the connection between post-salbutamol Persistent airflow limitation (PAL) at screening, airflow limitation (AL) during 52 weeks of extra-fine beclometasone dipropionate/formoterol fumarate/glycopyrronium (BDP/FF/G) versus BDP/FF, and the probability of moderate/severe asthma exacerbations using post-hoc analysis. TRIMARAN and TRIGGER were double-blind studies in individuals with uncontrolled asthma that compared BDP/FF/G with BDP/FF (TRIMARAN medium-dose ICS; TRIGGER high-dose). Patients were divided into 2 groups based on their post-salbutamol PAL status at screening and AL throughout the 52-week treatment period. At all on-treatment visits, most individuals with post-salbutamol PAL had AL (TRIMARAN 62.8%; TRIGGER 66.8%). On 1 follow-up visit, a significantly larger proportion of patients receiving BDP/FF/G than BDP/FF had normalised airflow (TRIMARAN 44.1 vs 33.1% [P=0.003]; TRIGGER 40.1 vs 26.0% [P<0.001]). Exacerbation rates were 15% (P=0.105) and 19% (P=0.039) lower in TRIMARAN and TRIGGER patients with post-salbutamol PAL at screening and normalized AL at more than or equal to 1 follow-up visit, respectively, compared to those with AL on all visits. Patients receiving BDP/FF/G had a reduced exacerbation rate than those getting BDP/FF, especially when AL was normalized. In these studies, AL was linked to an increased risk of asthma exacerbation. Extrafine BDP/FF/G inhaled triple therapy was more likely to normalize airflow and was linked to a reduced exacerbation rate than BDP/FF, especially in the subgroup of patients for whom treatment was linked to airflow normalization.
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