L'étude clinique du mois L'étude IMPACT dans la bronchopneumopathie chronique obstructive

The role of the anti-inflammatory and bronchodilator triple therapy, including a long acting ß2-agonist (LABA), a long-acting muscarinic antagonist (LAMA) and an inhaled corticosteroid (ICS), in the prevention of the exacerbations of chronic obstructive pulmonary disease (COPD) is still not clearly established, and requires comparison with dual therapy (LABA-CSI or LABA-LAMA). IMPACT is a phase 3, double-blind randomized study comparing the tritherapy (LABA-LAMA-ICS) in a single inhaler (vilanterol 25 µg/umeclidinium 62.5 µg/fluticasone furoate 100 µg) with the LABA-ICS association (vilanterol 25 µg-fluticasone furoate 100 µg) and the combination LABA-LAMA (vilanterol 25 µg/umeclidinium 62.5 µg) on the reduction of the rate of exacerbation as the primary outcome, but also on the pulmonary function, the quality of life, the dyspnea and the mortality.Triple therapy by comparison with dual therapy (LABA-ICS or LABA-LAMA) improves numerous parameters such as the rate of moderate to severe exacerbations, the symptoms, the respiratory function, the quality of life, while being well tolerated. Finally, the IMPACT study gives an “evidence base” for the GOLD guidelines proposing triple therapy in symptomatic COPD patients presenting exacerbations despite dual therapy. © Revue Medicale de Liege. All rights reserved.