Real-world evidence on improved adherence and asthma outcomes with single-inhaler triple therapy

<bold>Introduction:</bold> In the era of rapid advanced asthma treatment development adherence remains a major challenge in management of asthma, regardless of disease severity. Simplifying treatment with extrafine single-inhaler triple therapy (efSITT) offers a promising approach to enhancing adherence and improving asthma outcomes. <bold>Aims:</bold> To provide real-world evidence on the impact of medium dose efSITT (beclomethasone dipropionate 87 mcg/formoterol fumarate 5 mcg/glycopyrronium bromide 9 mcg) on adherence and clinical outcomes in asthma. <bold>Methods:</bold> A multicentre, national, prospective, non-interventional study was conducted in Slovenia, assessing patient characteristics and outcomes (Test of Adherence to Inhalers (TAI), Asthma Control Test (ACT), pulmonary function, exacerbation rates, and systemic steroid use) over 9–12 months of efSITT use. <bold>Results:</bold> A total of 349 asthma patients (59.3% women, mean age 61.9 years, 57.9% never-smokers) previously on ICS/LABA, with 28.7% using additional LAMA, were included. After 9–12 months on efSITT, significant improvements were observed in adherence (TAI score increased by 4.5 points, 95% CI: 4 to 5 points), disease control (ACT score: + 6 points, 95% CI: 6 to 6.5 points) and lung function (FEV1 change + 205 mL, 95% CI: 185 to 230 mL).12 months prior to inclusion, 79.7% of patients experienced exacerbations, compared to 15.2% afterward. Systemic steroid use was significantly reduced (Z = 9.02, p < 0.0001). <bold>Conclusion:</bold> Our findings confirm that efSITT significantly improves adherence and clinical outcomes in asthma, supporting the benefits previously demonstrated in RCTs within a real-world setting.