Introduction:

Achieving disease stability is emerging as a practical treatment goal in COPD, defined by the absence of exacerbations, preserved lung function, and stable health status. This analysis compared disease stability outcomes using composite definitions (SGRQ or CAT-based) in patients treated with triple therapy (FF/UMEC/VI) versus dual therapies (FF/VI or UMEC/VI).

Methods:

1. Study Design: Post hoc analysis of the 52-week, Phase III IMPACT trial
2. Population: 10,355 patients aged ≥40 years with symptomatic COPD and high exacerbation risk
3. Intervention:
   1. FF/UMEC/VI (N=4151)
   2. FF/VI (N=4134)
   3. UMEC/VI (N=2070)
4. Disease Stability Definitions:
   1. No moderate or severe exacerbation during the study period
   2. No more than a 100 mL decline in FEV₁ from baseline
   3. And one of the following health status criteria:
      1. SGRQ-containing definition: ≤4-point decline in SGRQ score from baseline
      2. CAT-containing definition: ≤2-point decline in CAT score from baseline

Maintenance of disease stability was assessed from baseline to Week 52Results:

Conclusion:

Triple therapy with FF/UMEC/VI led to a greater proportion of patients achieving and maintaining disease stability over 52 weeks, compared to dual therapies. These findings support disease stability as a meaningful treatment target in COPD and highlight FF/UMEC/VI's advantage in long-term control. Further work is needed to standardize component thresholds.

Am J Respir Crit Care Med 2025; 211: A1015

American Thoracic Society 2025 International Conference, May 18-21, San Francisco