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Lipson 2018 — IMPACT triple therapy

One-paragraph summary

IMPACT randomized symptomatic, exacerbation-prone COPD to once-daily single-inhaler triple therapy, ICS/LABA or LABA/LAMA. Triple therapy reduced moderate/severe exacerbation rates versus both dual regimens, while pneumonia was more frequent than with LABA/LAMA (PMID 29668352).

Key findings

  • Large phase 3 head-to-head comparison across three maintenance strategies.
  • Demonstrated exacerbation benefit and an explicit pneumonia tradeoff.

Limitations

  • Enriched exacerbation population limits low-risk generalization.
  • Prior ICS use and withdrawal at randomization complicate early-event and mortality interpretation.

Why it matters

It shaped contemporary triple-therapy escalation while defining the central benefit–harm debate.

Cited by wiki pages

  • Overview
  • Stable inhaled therapy