What question did this study set out to answer?

The study aims to evaluate clinical characteristics and biomarkers that determine the need for triple therapy in COPD patients.

February 11, 2026

Profiling High-risk Chronic Obstructive Pulmonary Disease Patients for Triple Therapy: Who Needs It Most?

Key Points

The study aims to evaluate clinical characteristics and biomarkers that determine the need for triple therapy in COPD patients.
Cross-sectional design
Conducted at Universitas Airlangga Hospital Pulmonary Clinic
Included male patients aged ≥40 years
Utilized spirometry and clinical evaluations
Analyzed data using SPSS with P < 0.05 for significance
64% of patients were ≥60 years old
74% were severe smokers with a high Brinkman index
82% exhibited moderate symptom burden per SGRQ
46% were at high exacerbation risk
Key factors for triple therapy included eosinophil counts ≥300 cells/μL and history of severe exacerbations.

Abstract

Abstract Background: Chronic obstructive pulmonary disease (COPD) remains a major contributor to global morbidity and mortality, carrying a substantial clinical and socioeconomic burden. Comprehensive identification of clinical characteristics, biomarkers, and treatment requirements is essential to guide optimal therapeutic strategies. This study aimed to evaluate the clinical determinants associated with the need for triple therapy in COPD patients. Methods: An analytical observational study with a cross-sectional design was conducted at the Pulmonary Clinic of Universitas Airlangga Hospital. Eligible participants were male patients aged ≥40 years who underwent spirometry and complete clinical evaluation. Patients with incomplete records or concomitant lung diseases were excluded. Clinical data, spirometry, and laboratory results were analyzed using SPSS, with P < 0.05 considered statistically significant. Results: A total of 50 patients were included. Most were ≥60 years (64%) and severe smokers (74%) with a mean Brinkman index of 827. The majority presented moderate symptom burden according to St. George’s Respiratory Questionnaire (SGRQ) (82%), moderate-to-severe functional limitation based on 6-min walk test (60%), and high exacerbation risk (46%). Significant factors associated with the need for triple therapy included blood eosinophil levels ( P < 0.001), exacerbation severity ( P = 0.001), impaired quality of life (SGRQ, COPD Assessment Test), comorbidity of myocardial infarction, and classification within the Airflow limitation, Burden of symptoms, and Exacerbation risk (ABE) Group. Conclusion: Triple therapy was predominantly required in patients with eosinophil counts ≥300 cells/μL, a history of severe exacerbations, and those classified as Group E in the ABE group. These patients exhibited poorer quality of life and higher comorbidity burden. The findings align with the WISDOM Trial, underscoring the importance of multidimensional assessment in guiding individualized COPD management.

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