What does this research mean for the field?

Triple therapy following hospitalization for acute COPD exacerbation does not improve overall three-year readmission or mortality rates, but significantly reduces these risks in patients with a history of frequent prior exacerbations. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to evaluate the long-term effectiveness of triple therapy following hospitalization for COPD exacerbations.

May 16, 2026Open Access

Real-World Long-Term Outcomes of Triple Therapy Following Hospitalization for Acute Exacerbation of COPD: A Retrospective Cohort Study

Key Points

This study aims to evaluate the long-term effectiveness of triple therapy following hospitalization for COPD exacerbations.
Retrospective cohort study of 500 hospitalized COPD patients from 2015 to 2023.
Patients were classified by their use of triple therapy during or shortly after hospitalization.
Cox models estimated adjusted hazard ratios and Kaplan–Meier methods were used for survival analyses.
329 patients (65.8%) received triple therapy, with no significant differences in readmission rates (aHR: 0.95, 95% CI: 0.66–1.35) or mortality (aHR: 0.88, 95% CI: 0.57–1.36).
Significant benefits were found in patients with ≥ 2 exacerbations prior to hospitalization (aHR for readmission: 0.14; aHR for mortality: 0.24).
Numerically lower risks were also noted in patients with baseline FEV1 ≥ 50% predicted (aHR for readmission: 0.57; aHR for mortality: 0.43).

Abstract

Purpose: Chronic obstructive pulmonary disease (COPD) exacerbations significantly accelerate disease progression and increase mortality and healthcare utilization. While triple therapy (inhaled corticosteroids/long-acting β 2 -agonist/long-acting muscarinic antagonist ICS/LABA/LAMA) is commonly prescribed to manage COPD, its long-term real-world effectiveness following hospitalization for acute exacerbation of COPD remains unclear. Patients and Methods: This retrospective cohort study included 500 patients hospitalized for severe COPD exacerbations at a tertiary hospital (2015– 2023). Patients were classified as receiving triple therapy (ICS/LABA/LAMA) during or within 7 days after the index hospitalization or not. Primary outcomes were COPD-related readmission and all-cause mortality within three years; secondary analyses were stratified by prior exacerbation frequency, baseline FEV 1 % predicted, and eosinophil count. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox models, with Kaplan–Meier methods for survival. Results: Among the study population, 329 patients (65.8%) received triple therapy. Overall, no significant differences were observed in three-year COPD-related readmission rates (adjusted hazard ratio aHR: 0.95, 95% confidence interval CI: 0.66– 1.35) or all-cause mortality (aHR: 0.88, 95% CI: 0.57– 1.36) between the groups. However, stratified analyses demonstrated significant benefits of triple therapy in patients with ≥ 2 exacerbations within one year prior to the index hospitalization (aHR for readmission: 0.14; aHR for mortality: 0.24) and showed numerically lower risks among those with baseline FEV 1 ≥ 50% predicted (aHR for readmission: 0.57; aHR for mortality: 0.43). Conclusion: Triple therapy was not associated with improved outcomes in the overall cohort but may be associated with better outcomes in selected high-risk subgroups. These findings should be interpreted with caution given the observational design and potential residual confounding. Further studies are warranted to confirm these findings and refine patient selection for triple therapy. Keywords: COPD exacerbation, triple therapy, mortality, real-world study, retrospective cohort

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Cite This Study

Su et al. (Fri,) studied this question.

synapsesocial.com/papers/6a080b84a487c87a6a40d96a https://doi.org/https://doi.org/10.2147/copd.s586308

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