FIGURE 1.

The potential mechanisms by which inhaled triple therapy may modify the course of COPD over time. Inhaled triple therapy containing an inhaled corticosteroid/long-acting β2-agonist/long-acting muscarinic antagonist has been shown to improve lung function, reduce exacerbations, lower mortality and prevent cardiovascular events in patients with moderate-to-severe COPD over 1 year [11, 12]. If these benefits remain resilient across decades of therapy, according to DEPICT-2, dual or triple therapy can significantly modify the natural course of COPD and reduce its burden of disease.