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Table 1 Details of included RCTs

From: Single-inhaler triple vs single-inhaler dual therapy in patients with chronic obstructive pulmonary disease: a meta-analysis of randomized control trials

Number

Study

Study design

Duration of follow-up

Inclusion criteria

Exclusion criteria

Drugs, Doses (μg), Regimen, Device

No of patients

1

TRILOGY Singh, 2016

A randomized, parallel group, double-blind, active-controlled study

52 weeks

FEV1 < 50% predicted, moderate or severe COPD exacerbation in the previous 12 months ≥ 1, CAT score ≥ 10, BDI score ≤ 10

Asthma, history of allergic rhinitis; clinically significant cardiovascular conditions

BDP/FOR/GLY (100/6/12.5) bid MDI

687

BDP/FOR (100/6) bid MDI

680

2

FULFIL Lipson,2017

A phase 3, randomized, double-blind, double-dummy, parallel-group, multicentre study

24 weeks

FEV1 < 50% predicted and CAT score ≥ 10; 50% ≤ FEV1 < 80% predicted and CAT score ≥ 10 or moderate COPD exacerbation in the previous 12 months ≥ 2 or severe COPD exacerbation in the previous 12 months ≥ 1

Asthma, unresolved pneumonia, severe COPD exacerbation

FF/UMEC/VI (100/62.5/25) od DPI

911

BUD/FOR (400/12) bid DPI

899

3

IMPACT Lipson,2018

A phase 3, randomized, double-blind, parallel-group, multicentre trial

52 weeks

FEV1 < 50% predicted and moderate or severe COPD exacerbation in the previous 12 months ≥ 1; 50% ≤ FEV1 < 80% predicted and moderate COPD exacerbation in the previous 12 months ≥ 2 or severe COPD exacerbation in the previous 12 months ≥ 1

Not reported

FF/UMEC/VI (100/62.5/25) od DPI

4151

FF/VI (100/25) od DPI

4134

UMEC/VI (62.5/25) od DPI

2070

4

KRONOS Ferguson,2018

A randomized, double-blind, parallel-group, phase 3 randomized controlled trial

24 weeks

25% ≤ FEV1 < 80% predicted; CAT score ≥ 10. Patients were not required to have had a COPD exacerbation within the preceding year

Asthma, diagnosis of any respiratory disease

BUD/GLY/FOR (320/18/9.6) bid MDI

639

GLY/FOR (18/9.6) bid MDI

625

BUD/FOR (320/9.6) bid MDI

314

5

TRIBUTE Papi,2018

A randomized, parallel-group, double-blind, double-dummy, active-controlled phase 3b study

52 weeks

FEV1 < 50%, a moderate or severe COPD exacerbation in the previous 12 months ≥ 1, CAT score ≥ 10

Asthma; clinically significant cardiovascular disorders

BDP/FOR/GLY (100/6/10) bid MDI

764

IND/GLY (85/43) od DPI

768

6

ETHOS Rabe,2020

A phase 3, randomized, double-blind, parallel-group, multicentre trial

52 weeks

FEV1 < 50% predicted and moderate or severe COPD exacerbation in the previous 12 months ≥ 1; FEV1 ≥ 50% predicted and moderate COPD exacerbation in the previous 12 months ≥ 2 or severe COPD exacerbation in the previous 12 months ≥ 1, CAT ≥ 10

Current diagnosis of asthma

BUD/GLY/FOR (320/18/9.6) bid MDI

2144

BUD/GLY/FOR (160/18/9.6) bid MDI

2124

BUD/FOR (320/9.6) bid MDI

2136

GLY/FOR (18/9.6) bid MDI

2125

  1. BDP/FOR/GLY: beclomethasone dipropionate/formoterol fumarate/glycopyrronium bromide; BUD/GLY/FOR: budesonide/glycopyrronium bromide/formoterol fumarate; FF/UMEC/VI: fluticasone furoate/umeclidinium/vilanterol; BDP/FOR: beclomethasone dipropionate/formoterol fumarate; BUD/FOR: budesonide/formoterol fumarate; UMEC/VI: umeclidinium bromide/vilanterol; GLY/FOR: glycopyrronium bromide/formoterol fumarate; IND/GLY: indacaterol/glycopyrronium bromide; OD: once daily; BID: twice daily; MDI: metered-dose inhaler formulation; DPI: dry powder inhaler formulation; FEV1: forced expiratory volume in 1 s; BDI: Baseline Dyspnea Index; CAT: COPD assessment test; RCT: Randomized controlled trial