Triple combinations in asthma therapy: for whom and when: a clinical case

Bolotova E.V., Shulzhenko L.V., Bozhko O.V.

1) Kuban State Medical University, Krasnodar, Russia; 2) Research Institute – Regional Clinical Hospital No. 1 named after S.V. Ochapovsky, Krasnodar, Russia

According to clinical guidelines, patients with bronchial asthma (BA) who have not achieved control on therapy with medium and high doses of inhaled glucocorticosteroids (IGCS) in combination with long-acting β2-adrenoreceptor agonists (LABA) and the presence of one or more exacerbations over the past year are recommended to be prescribed a fixed triple combination of IGCS/LABA/long-acting muscarinic receptor antagonist (LAMA). The presented clinical case justifies the escalation of basic therapy in patients with severe bronchial asthma when the dual combination (IGCS/LABA) is ineffective, to a fixed triple combination of IGCS/LABA/LAMA (mometasone/indacaterol/glycopyrronium bromide). The feature of the presented clinical case is the presence of fixed bronchial obstruction and obesity in the patient. Therapy with a fixed triple combination led to an improvement in the patient’s condition, including increased exercise tolerance, a decrease in the frequency of asthma attacks and improved spirometry. No side effects were registered. Based on the above, the following conclusions were made: the fixed triple combination of mometasone/indacaterol/glycopyrronium bromide is highly effective, safe for the patient, a single daily dose of the drug improves adherence
to therapy.

Keywords

About the Authors

Elena V. Bolotova, Dr. Sci. (Med.), Professor, Professor at the Department of Therapy No. 1, Kuban State Medical University, Krasnodar, Russia; bolotowa_e@mail.ru, ORCID: https://orcid.org/0000-0001-6257-354X, AuthorID: 277732 (corresponding author)
Larisa V. Shulzhenko, Dr. Sci. (Med.), Head of the Department of Pulmonology, Kuban State Medical University Head of the Department of Pulmonology, Research Institute – Regional Clinical Hospital No. 1 named after S.V. Ochapovsky, Krasnodar, Russia; larisa_shulzhenko@mail.ru, ORCID:
https://orcid.org/0000-0002-2110-0970, AuthorID: 725189
Oksana V. Bozhko, pulmonologist of the Department of Pulmonology, Research Institute – Regional Clinical Hospital No. 1 named after S.V. Ochapovsky, Krasnodar, Russia; ice_oksi@mail.ru, ORCID: https://orcid.org/0000-0002-8273-7326; AuthorID: 1118519