From the Guidelines
I strongly recommend continuing Trelegy for the inpatient to maintain control of respiratory symptoms and prevent exacerbations. Trelegy Ellipta is a once-daily inhaled medication containing fluticasone furoate (an inhaled corticosteroid), umeclidinium (a long-acting muscarinic antagonist), and vilanterol (a long-acting beta-agonist) that should be maintained during hospitalization for patients with COPD or asthma 1. The standard dose is one inhalation daily. Abrupt discontinuation of this medication can lead to worsening respiratory symptoms, potential exacerbations, and deterioration in lung function.
When administering in the hospital, ensure the patient uses proper inhaler technique and takes the medication at the same time each day to maintain consistent drug levels. If the patient cannot use the inhaler independently, nursing assistance should be provided. Monitor for potential side effects including oral thrush, hoarseness, increased heart rate, and tremor. Trelegy works by reducing airway inflammation, relaxing airway smooth muscles, and preventing bronchoconstriction through its triple mechanism of action, providing comprehensive control of respiratory symptoms during the vulnerable period of hospitalization.
Key considerations for inpatient management include:
- Maintaining consistent medication schedules to prevent exacerbations
- Monitoring for potential side effects and adjusting treatment as needed
- Ensuring proper inhaler technique to maximize medication efficacy
- Providing nursing assistance for patients who cannot use the inhaler independently
- Considering the patient's overall medical status and adjusting treatment accordingly 1.
It is essential to prioritize the patient's respiratory health and maintain continuity of care during hospitalization to prevent complications and improve outcomes 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Trelegy Ellipta for COPD Treatment
- Trelegy Ellipta is a dry powder inhaler containing fluticasone furoate, vilanterol trifenatate, and umeclidinium bromide, licensed for once-daily use as maintenance treatment for adults with moderate to severe COPD 2.
- The combination of inhaled corticosteroids, long-acting β2 agonists, and long-acting muscarinic receptor antagonists can be used for group D COPD patients who are at high risk for exacerbations 3.
Efficacy of Trelegy Ellipta
- Studies have shown that triple therapy with Trelegy Ellipta is more effective than dual therapies in reducing the rate of moderate-severe exacerbations, improving trough FEV1, and improving quality of life 4.
- A real-world comparative effectiveness study found that Trelegy Ellipta was associated with significantly lower rate and risk of COPD exacerbations compared to budesonide/glycopyrrolate/formoterol fumarate 5.
Safety Profile
- The safety profile of Trelegy Ellipta has been shown to be good, without excess cardiovascular effects or pneumonia, although the presence of comorbidities was frequent 4.