Journal Article

Real-World Effectiveness of Single-Inhaler Triple Treatment Through Assorted Respiratory Outcomes When Switched From Multiple-Inhaler Triple Therapies (RESTART): A Prospective Cohort Study of Korean Patients With COPD

Shin, Juyoung, Lee, Seung Jun, Lee, Hyesung, Shin, Kyeongcheol, Ra, Seung Won, Kim, Dong Han, Lim, Hana, Hong, Song Hee

2025

Overview

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition characterized by persistent airflow limitation, leading to significant morbidity and mortality. Despite the effectiveness of multiple inhaler triple therapy (MITT), its complexity often results in poor adherence and suboptimal outcomes. Transitioning to single inhaler triple therapy (SITT) may enhance adherence, leading to improved clinical outcomes and quality of life of patients. The Real-World Effectiveness of Single Inhaler Triple Treatment through Assorted Respiratory Outcomes when Switched from Multiple Inhaler Triple Therapies (RESTART) study aimed to evaluate the clinical benefits of switching from MITT to SITT using fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) in a real-world Korean setting. This prospective, multicenter, observational study enrolled 107 patients, aged 40 and older, with diagnosed COPD, all previously on MITT. The patients were transitioned to once-daily FF/UMEC/VI administered via the ELLIPTA inhaler. The primary outcome was a change in the COPD Assessment Test (CAT) score after 24 weeks. The secondary outcomes included changes in lung function, exacerbation rates, Modified Medical Research Council Dyspnea Scale scores, and Treatment Satisfaction-Visual Analysis Scale (TS-VAS) scores. A total of 91 patients completed the 24-week observation. CAT scores significantly improved (mean change = 1.40 points, = 0.007). Lung function also improved, with a mean increase in the FEV1/FVC ratio (mean change = 4.31%, = 0.005). Exacerbation rates decreased significantly (incidence rate ratio = 0.45, = 0.016). Treatment satisfaction increased, with a mean TS-VAS score rise of 1.71 points ( < 0.001). The transition from MITT to SITT significantly improved COPD symptom management, pulmonary function, exacerbation rate, and treatment satisfaction in Korean cohort. Using a single inhaler to simplify therapy might increase patient compliance and improve clinical outcomes of COPD management.

• Publisher: Dove Medical Press Limited,Dove Medical Press Ltd,Dove Press,Dove,Dove Medical Press
• Subject: adherence / Administration, Inhalation / Adrenergic beta-2 Receptor Agonists - administration & dosage / Adrenergic beta-2 Receptor Agonists - adverse effects / Adult / Aged / Androstadienes / Benzyl Alcohols - administration & dosage / Benzyl Alcohols - adverse effects / Bronchodilator Agents - administration & dosage / Bronchodilator Agents - adverse effects / Chlorobenzenes - administration & dosage / Chlorobenzenes - adverse effects / Chronic obstructive pulmonary disease / chronic obstructive pulmonary disease assessment test score / Clinical outcomes / Cohort analysis / Drug Combinations / Drug dosages / Drug Substitution / Drug therapy / Female / Forced Expiratory Volume / Humans / Inhalers / Lung - drug effects / Lung - physiopathology / Lung diseases / Male / Medical research / Medicine, Experimental / Middle Aged / Mortality / Muscarinic Antagonists - administration & dosage / Muscarinic Antagonists - adverse effects / Nebulizers and Vaporizers / Original Research / Patient compliance / Patient outcomes / Patients / Prospective Studies / Pulmonary Disease, Chronic Obstructive - diagnosis / Pulmonary Disease, Chronic Obstructive - drug therapy / Pulmonary Disease, Chronic Obstructive - physiopathology / Quality of Life / Quinuclidines - administration & dosage / Quinuclidines - adverse effects / real-world evidence / Recovery of Function / Republic of Korea / single-inhaler triple treatment / Time Factors / Tiotropium / Treatment Outcome / Vital Capacity