There are 65 million people worldwide have moderate to severe COPD and more than 3 million people died of COPD in 2005 globally. It is projected that COPD will be the third leading cause of death worldwide in 2030.
In Malaysia COPD is the top 5 causes of death after ischaemic heart attack, lower respiratory tract infection, stroke and road traffic accidents. The aim of treatment for COPD according to GOLD 2021 is to reduce symptoms and reduce risk of exacerbation. Severe exacerbation carries approximately 16% mortality rate in patient with COPD.
Bronchodilator is the mainstay of treatment for COPD.Dual bronchodilator LABA/LAMA improve dyspnoea, exercise tolerance, lung function and quality of life compared to its monotherapy and combination LABA/ICS. Inhaled corticosteroid (ICS) plays an important role in selected COPD patients. The use of ICS in combination with LABA/LAMA as a triple therapy has been shown to reduce moderate to severe exacerbation compared to dual bronchodilator. The role of triple therapy benefits GOLD D COPD, patients with concomitant asthma and patients with elevated blood eosinophils.