FUNCTIONAL AND DIAPHRAGMATIC EFFECTS OF TRIPLE INHALED THERAPY BECLOMETHASONE DIPROPIONATE/FORMOTEROL FUMARATE/GLYCOPYRRONIUM IN PATIENTS WITH UNCONTROLLED ASTHMA

Triple inhaler therapy beclomethasone dipropionate/formoterol fumarate/glycopyrronium (BDP/FF/G) is the first approved “extra-fine” formulation for treatment of uncontrolled asthma. The aim of our “real-life” study is to evaluate efficacy of BDP/FF/G in patients with uncontrolled asthma. Data were evaluated at the baseline and after 1 month of BDP/FF/G 172/5/9 mcg. Seven patients with uncontrolled asthma treated with ICS/LABA were enrolled. Compared with baseline parameters, after one month of BDP/FF/G, significant changes were observed in FEF25-75 (0.92 ± 0.61 L/s vs. 1.24 ± 0.75 L/s; p < 0.05) and FEV1 (1.41 ± 0.57 L vs. 1.72 ± 0.63 L; p < 0.05). In addition, we observed the reduction of Rtot (0.65 ± 0.29 kPa*s/L vs. 0.48 ± 0.36 kPa*s/L; p < 0.05), Reff (0.62 ± 0.30 kPa*s vs. 0.47 ± 0.28 kPa*s; p < 0.05). and RV (2.35 ± 0.64 L vs. 1.60 ± 0.72 L; p < 0.05). We also found improvement in ACT (15.14 ± 1.34 vs. 20.71 ± 2.05; p < 0.001). With regard to ultrasound, reduction in diaphragmatic "thickening fraction" (TF) (58.40 ± 13.24 % vs. 43.80 ± 18.86 %; p < 0.05) and increase in inspiratory time (0.92 ± 0.05 s vs. 1.05 ± 0.06 s; p < 0.05) were observed. In addition, by running "correlation matrix," statistically significant correlations emerged between increase in FEV1 and decrease in Rtot (r = -0.882; p < 0.01), increase in FEV1 and increase in ACT (r = 0.804; p < 0.05), decrease in Rtot and increase in ACT (r = 0.804; p < 0.05), increase in FEF25-75 and decrease in TF (r = -0.879; p < 0.01). These preliminary results highlight the efficacy of BDP/FF/G in the treatment of uncontrolled asthma, with positive effects on diaphragmatic work.