Abstract / Summary
Background: COPD is associated with long-term dyspnea and exacerbations. This research compared effects of using dual (LABA/LAMA) and triple (LABA/LAMA/ICS) inhaler therapy on dyspnea and exacerbations in COPD patients. Methods: It was a comparative cohort study that was carried out by the Department of Pulmonology, Khyber Teaching Hospital, Peshawar, from January to June 2026. Consecutive sampling (non-probability) was conducted to enroll 336 COPD patients, although 168 cases took dual and 168 cases took triple therapy. Dyspnea was measured with modified Medical Research Council (mMRC) at baseline and follow up. Exacerbations were noted also. The SPSS version 26 was used in analysis of data through the use of parametric and non-parametric tests and multivariate logistic regression. Results: Follow-up mMRC scores were lower with triple therapy than dual therapy (1.54 ± 0.94 vs. 2.18 ± 1.02; p<0.001). Mean mMRC improvement was greater with triple therapy (1.31 ± 0.76 vs. 0.64 ± 0.72; p<0.001). There was an improvement in clinical condition of 81.0% compared to 54.8% of the patients (p<0.001). Total exacerbations were also lower with triple therapy (3.2 ± 1.9 vs. 4.4 ± 2.3; p<0.001). Multivariate analysis revealed that triple therapy was still significantly correlated with the clinical improvement (AOR 3.42, 95% CI: 2.10-5.58; p<0.001). Conclusion: Triple therapy has been linked to higher improvement of dyspnea and reduce exacerbation compared to dual therapy.