A triple-therapy inhaler like Trelegy is indicated for COPD patients with which feature?

• A. Age over 60
• B. Normal CAT score
• C. Eosinophil count high
• D. Frequent exacerbations

Answer: (D)

The main idea is that stepping up to a triple therapy inhaler is guided by the risk of COPD exacerbations and overall symptom burden, not simply by age or a single lab value. Trelegy combines an inhaled corticosteroid, a long-acting muscarinic antagonist, and a long-acting beta-agonist, and is used for patients whose COPD remains at risk or poorly controlled on simpler regimens.

Frequent exacerbations is the best match because a history of repeated COPD flare-ups signals ongoing instability that often benefits from the added anti-inflammatory effect of an inhaled corticosteroid alongside dual bronchodilation. High eosinophil count can suggest potential ICS benefit, but it doesn’t alone justify triple therapy; it’s the recurrent exacerbations that most strongly indicate escalation. Age over 60 and a normal CAT score don’t define the need for triple therapy.