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Synopsis: Despite clinical guidelines recommending triple therapy with an inhaled corticosteroid (ICS), long-acting muscarinic receptor antagonist (LAMA), and long-acting beta-agonist (LABA) for individuals with GOLD D chronic obstructive pulmonary disease, the evidence supporting this is weak. The IMPACT study was a randomized controlled trial that provided evidence that exacerbation risk is decreased in patients using triple therapy compared with an ICS/LABA or LAMA/LABA.Source: Lipson DA, Barnhart F, Brealey N, et al. Once-daily single-inhaler triple versus dual therapy in patients with chronic obstructive pulmonary disease. N Engl J Med 2018;378(18):1671–1680.