COPD triple therapy treatment guidelines: Are you up-to-date?

To help you navigate the latest national guidelines we have provided you with a summary of the recommendations when treating moderate-to-severe patients with COPD:

NICE COPD treatment guidelines

From July 2019, NICE COPD treatment guidance recommends triple therapy for patients with COPD who are on dual therapy and have either day-to-day symptoms that adversely impact quality of life or, have had 1 severe or 2 moderate exacerbations within a year.¹

Whilst NICE did not make a specific recommendation around whether an ICS/LABA/LAMA treatment should be delivered in multiple inhalers or a single inhaler they did comment as follows:

From the economic evidence, using a single inhaler device was more cost effective¹

Minimise the number of inhalers and different types of inhalers used by each person where possible¹

NICE recommendations are for classes of medicine, they do not recommend Trelegy Ellipta specifically.

LAMAs and LAMA/LABAs are indicated as maintenance bronchodilator treatments to relieve symptoms in adult patients with COPD
AnoroEllipta (umeclidinium bromide/vilanterol) SmPC. Spiolto Respimat SmPC. Ultibro Breezhaler SmPC. Incruse Ellipta (umeclidinium) SmPC. Seebri Breezhaler SmPC)

Patients on LAMA/LABA who have day-to-day symptoms adversely impacting their quality of life NICE recommends a 3 month trial with ICS/LABA/LAMA and if no improvement to revert to LAMA/LABA.¹

NICE COPD guidelines algorithm

Would you like to see the full NICE COPD treatment guidelines?


ICS, inhaled corticosteroid; LABA, long-acting ß₂-agonist; LAMA, long-acting muscarinic antagonist

Trelegy Ellipta OD is indicated for maintenance treatment in adult patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) who are not adequately treated by a combination of an ICS and a LABA, or a combination of a LAMA and a LABA.²

Trelegy Ellipta is generally well tolerated. Common adverse reactions include: headache, nasopharyngitis, influenza, upper respiratory tract infection, pneumonia, back pain, rhinitis, cough, pharyngitis, arthralgia, sinusitis, oropharyngeal pain, bronchitis, constipation, candidiasis of mouth and throat, urinary tract infection.²

In common with other corticosteroid-containing medicines, there is an increased risk of pneumonia in patients with COPD treated with Trelegy Ellipta.²


  1. (Last accessed: May 2020)
  2. Trelegy Ellipta SmPC.

Adverse events should be reported. Reporting forms and information can be found at or search for MHRA Yellowcard in the Google Play or Apple App store. Adverse events should also be reported to GlaxoSmithKline on 0800 221 441.

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Trelegy Ellipta was developed in collaboration with

PM-GB-FVU-WCNT-200010 | July 2020