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

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 improvements to revert to LAMA/LABA.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 COPD recommendations are for classes of medicine they do no specifically endorse Trelegy Ellipta or the Ellipta device.

NICE COPD guidelines algorithm

NICE COPD Guidelines Algorithm NICE COPD Guidelines Algorithm

LAMAs and LAMA/LABAs are indicated as maintenance bronchodilator treatments to relieve symptoms in adult patients with COPD

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

Prescribing Information Links

Trelegy Ellipta Prescribing Information (pdf)

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 inhaled corticosteroid and a long-acting β2-agonist or a combination of a long-acting β2-agonist and a long-acting muscarinic antagonist.2


ICS, inhaled corticosteroid; LABA, long-acting β2-agonist; LAMA, long-acting muscarinic antagonist


  1. NICE;2019 Chronic Obstructive Pulmonary Disease in over 16s: diagnosis and management
  2. Trelegy Ellipta SmPC.
  3. NICE Chronic Obstructive Pulmonary Disease in over 16s: non pharmacological May 2019

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.

August 2022 | PM-GB-FVU-WCNT-200010 (V3.0)