Role of ICS and place of triple therapy in COPD - GOLD 2023 

Inhaled corticosteroid plays important role in the management of COPD patients having history of hospitalization due to COPD exacerbation, or history of two or more than two moderate COPD exacerbation, with blood eosinophil count of more than 300 cells/ul. The IMPACT and ETHOS studies have shown that triple therapy (ICS+LABA+LAMA) in a single inhaler therapy is associated with significant reduction in the risk of all cause mortality in COPD patients compared to dual therapy with LABA+LAMA. GOLD 2023 report recommends triple therapy with ICS, LABA and LAMA single inhaler therapy in COPD group E category patients having blood eosinophil count of more than 300 cells/ul.