{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T12:22:22Z","timestamp":1793190142424,"version":"4.5.0"},"reference-count":23,"publisher":"European Respiratory Society (ERS)","issue":"5","license":[{"start":{"date-parts":[[2020,4,16]],"date-time":"2020-04-16T00:00:00Z","timestamp":1586995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"GSK","award":["CTT116855, NCT02164513"],"award-info":[{"award-number":["CTT116855, NCT02164513"]}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2020,2,17]]},"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:p>IMPACT, a 52-week, randomised, double-blind trial, assessed the efficacy and safety of fluticasone furoate\/umeclidinium\/vilanterol (FF\/UMEC\/VI) triple therapy<jats:italic>versus<\/jats:italic>FF\/VI or UMEC\/VI in patients with symptomatic COPD and a history of exacerbations.<\/jats:p><jats:p>Subgroup analyses assessed whether the efficacy of FF\/UMEC\/VI<jats:italic>versus<\/jats:italic>FF\/VI or UMEC\/VI and UMEC\/VI<jats:italic>versus<\/jats:italic>FF\/VI varies according to prior exacerbation history, and the combined effects of exacerbation history and blood eosinophil counts. Three subgroups were defined: single moderate (1 moderate\/no severe; n=3056 (30%)), frequent moderate (\u22652 moderate\/no severe; n=4628 (45%)) and severe (\u22651 severe\/any moderate; n=2671 (26%)). End-points included annual on-treatment moderate\/severe exacerbation rate (pre-specified), lung function and health status (both post-hoc).<\/jats:p><jats:p>Moderate\/severe exacerbation rates (reduction % (95% CI)) were reduced in the FF\/UMEC\/VI group<jats:italic>versus<\/jats:italic>FF\/VI (single moderate 20% (10\u201329), frequent moderate 11% (2\u201319), severe 17% (7\u201326)) and<jats:italic>versus<\/jats:italic>UMEC\/VI (single moderate 18% (5\u201329), frequent moderate 29% (21\u201337), severe 26% (14\u201335)). Moderate\/severe exacerbation rates were reduced in the FF\/VI group<jats:italic>versus<\/jats:italic>UMEC\/VI in the frequent moderate subgroup; a numerical reduction was observed in the severe subgroup (single moderate 2% (\u221212\u201318), frequent moderate 21% (11\u201329), severe 11% (\u22123\u201322)). Moderate\/severe exacerbation rates were lower in the FF\/VI group compared with UMEC\/VI in patients with higher eosinophil counts. FF\/UMEC\/VI improved lung function and health status<jats:italic>versus<\/jats:italic>both dual therapies irrespective of exacerbation subgroup. UMEC\/VI improved lung function<jats:italic>versus<\/jats:italic>FF\/VI in all subgroups.<\/jats:p><jats:p>Triple therapy was more effective than dual regardless of exacerbation history, consistent with results in the intent-to-treat population. Comparisons between dual therapies were influenced by prior exacerbation history and eosinophil counts.<\/jats:p>","DOI":"10.1183\/13993003.01921-2019","type":"journal-article","created":{"date-parts":[[2020,4,16]],"date-time":"2020-04-16T22:15:25Z","timestamp":1587075325000},"page":"1901921","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":41,"title":["The effect of exacerbation history on outcomes in the IMPACT trial"],"prefix":"10.1183","volume":"55","author":[{"given":"David M.G.","family":"Halpin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark T.","family":"Dransfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MeiLan K.","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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