Single-Inhaler Triple Therapy and Health-Related Quality of Life in COPD: The IMPACT Study

Maggie Tabberer, C. Elaine Jones, Sally Kilbride, David M.G. Halpin, David A. Lomas, Steven Pascoe, Dave Singh, Robert A. Wise, Gerard J. Criner, Peter Lange, Mark T. Dransfield, Mei Lan K. Han, Fernando J. Martinez, Morrys C. Kaisermann, David A. Lipson

Research output: Contribution to journalArticlepeer-review


Introduction: The phase 3 InforMing the PAthway of COPD (chronic obstructive pulmonary disease) Treatment (IMPACT) trial, single-inhaler therapy with fluticasone furoate (FF) 100 μg, umeclidinium (UMEC) 62.5 μg, and vilanterol (VI) 25 μg demonstrated a reduction in the rate of moderate or severe exacerbations compared with FF/VI or UMEC/VI in patients with symptomatic COPD at risk of exacerbations. This article reports additional evidence of improvements in symptoms and health-related quality of life (HRQoL) with FF/UMEC/VI compared with either FF/VI or UMEC/VI from the IMPACT study. Methods: Patient-reported HRQoL assessments and symptom measures included as pre-specified IMPACT end points were the St George's Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT), and Baseline Dyspnea Index (BDI) as the anchor for the Transitional Dyspnea Index (TDI) focal score (BDI/TDI) in a subset of patients enrolled at study sites in North America and Europe. Change from baseline was assessed at weeks 4, 28, and 52. Results: The intent-to-treat population included 10,355 patients (TDI population: 5058 patients). Clinically meaningful improvements in SGRQ total score between baseline and week 52 favored FF/UMEC/VI over FF/VI (− 1.8 units, p < 0.001) and UMEC/VI (− 1.8 units, p < 0.001). Similar improvements in the CAT and TDI focal score were also observed with FF/UMEC/VI versus FF/VI or UMEC/VI. Conclusions: This study demonstrates that in patients with symptomatic COPD at risk of exacerbations, once-daily FF/UMEC/VI, compared with FF/VI or UMEC/VI, improves patient-perceived HRQoL and symptoms. Trial Registration Number: NCT02164513.

Original languageEnglish (US)
Pages (from-to)3775-3790
Number of pages16
JournalAdvances in Therapy
Issue number9
StatePublished - Sep 1 2020


  • COPD
  • Exacerbations
  • Health-related quality of life
  • IMPACT trial
  • Patient-reported outcomes
  • Single-inhaler triple therapy

ASJC Scopus subject areas

  • Pharmacology (medical)


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