What are the alternatives to Trelegy (fluticasone furoate, umeclidinium, and vilanterol)?

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Last updated: May 27, 2025View editorial policy

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From the Guidelines

Breztri Aerosphere is the most suitable alternative to Trelegy, as it contains a similar triple therapy combination of budesonide, glycopyrrolate, and formoterol, which has been shown to provide benefits in COPD management, including a reduction in exacerbations and improvement in health-related quality of life 1.

When considering alternatives to Trelegy, it's essential to evaluate the patient's specific respiratory condition, symptom severity, and tolerance to medications. Breztri Aerosphere, Anoro Ellipta, and Breo Ellipta are potential options, each with its own mechanism of action and benefits.

  • Breztri Aerosphere: This triple therapy provides similar benefits to Trelegy, including reducing airway inflammation, relaxing airway muscles, and preventing bronchoconstriction.
  • Anoro Ellipta: Offers a dual bronchodilator approach without the steroid component, which may be suitable for patients who don't require triple therapy.
  • Breo Ellipta: Combines a steroid with one bronchodilator, providing an alternative for patients who require a steroid component.

The choice of alternative depends on individual patient needs, and dosing regimens should be determined by a healthcare provider, taking into account the patient's specific condition and potential side effects, as noted in studies such as the UPLIFT study, which assessed the effect of tiotropium on the incidence of dyspnea 1.

From the Research

Alternative to Trelegy

  • There are several alternatives to Trelegy, including other triple combination therapies and dual combination therapies 2, 3, 4, 5.
  • Budesonide/formoterol is a combination inhaled steroid and long-acting bronchodilator that has been shown to be effective in addressing many important aspects of COPD, such as pulmonary function, symptoms, and health-related quality of life 3.
  • A study comparing budesonide/formoterol with tiotropium found that the combination therapy was associated with a 22% reduction in risk of COPD exacerbation and lower COPD-related health care resource utilization and costs 4.
  • Another study found that budesonide/glycopyrronium/formoterol fumarate had comparable efficacy and safety to other triple combination therapies, including fluticasone furoate/umeclidinium/vilanterol, in patients with moderate-to-very-severe COPD 5.
  • However, a study comparing patient experience with Trelegy versus other inhalers found that patients using Trelegy had greater symptoms, but did not differ in adherence, medication attitudes, or medication beliefs 6.

Comparison of Alternatives

  • The following alternatives to Trelegy have been studied:
    • Budesonide/formoterol 3, 4
    • Tiotropium 4
    • Budesonide/glycopyrronium/formoterol fumarate 5
    • Fluticasone furoate/umeclidinium/vilanterol 5
  • These alternatives have been shown to have varying degrees of efficacy and safety in patients with COPD 3, 4, 5.

Patient Experience

  • Patient experience with Trelegy versus other inhalers has been studied, with findings suggesting that patients using Trelegy had greater symptoms, but did not differ in adherence, medication attitudes, or medication beliefs 6.
  • However, the study recommended that clinicians regularly re-evaluate their Trelegy recommendations, as Trelegy use may not be the best therapy for certain patients 6.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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