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Triple inhaled therapy for Chronic Obstructive Pulmonary Disease (COPD) includes an Inhaled Corticosteroid (ICS), a Long-Acting b2-Agonist (LABA) and a Long-Acting Muscarinic Antagonist (LAMA) taken in combination. Triple therapy is recommended by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) for patients who experience recurrent exacerbations despite treatment with either a dual bronchodilator or LABA/ICS combination. There is consistent evidence that the LABA/LAMA/ICS combination has significantly greater effects on trough FEV1, symptoms, quality of life, and exercise performance compared to comparator treatments. The role of triple therapy in reducing exacerbations is still debated, but some recent trials have clarified the correct use of triple therapy in COPD. Three pivotal studies have been conducted to evaluate the safety and efficacy of extra fine Beclomethasone/Formoterol Fumarate/Glycopyrronium Bromide (BDP/FF/GB) versus different treatment options for COPD: extra fine BDP/FF/GB has been compared to an ICS/LABA (BDP/FF) combination in the TRILOGY study, to a LAMA monotherapy (Tiotropium, TIO) and an extemporary triple combination of ICS/LABA + LAMA (BDP/FF - TIO) in the TRINITY study, and to one inhalation of LABA/LAMA per day (Indacaterol/Glycopirronium, IND/GLY) in the TRIBUTE study. Another triple therapy with Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI) was recently tested in two studies including patients with COPD. The FULFIL compared the efficacy of the triple FF/UMEC/VI therapy to the ICS/LABA association budesonide/formoterol, while the IMPACT study compared the rate of moderate and severe exacerbations between singleinhaler FF/UMEC/VI and single-inhaler FF/VI or UMEC/VI. [ABSTRACT FROM AUTHOR]