When we decide to take a drug to protect our health we just want it to be effective and work over time. But later we realize that it is not enough because, especially in chronic treatments, you have to deal with everyday life, remembering to take the therapy at the right times or to take it with you. Thus the best drug becomes the one that looks like our favorite dress, which we take from the closet and wear with closed eyes. Something similar happens in the treatment of respiratory diseases such as Chronic Obstructive Pulmonary Disease (BPCO). For a ‘tailor-made’ therapy – reads a note from GSK – the ‘dress’, that is the drugs chosen by the doctor, must be the optimal ones for the patient’s condition. But it is also essential that the ‘fit and comfort’, that is the device that allows you to inhale them and offer the amount of active ingredients needed directly where they are needed, is preferred by the patient and which in this case means above all that it is simple to use. Thus the conditions are created to ensure therapeutic adherence, which represents the main challenge in the treatment of BPCO in everyday life. If the patient follows the indicated therapy correctly, the results in terms of symptom control and reduction of the risk of exacerbations and hospitalization are better, together with a more favorable short- and long-term prognosis. ‘Intrepid’ study (INvestigation of TRelegy Effectiveness: usual Practice Design: a single- versus multiple-inhaler triple therapy for COPD in usual clinical practice), conducted to verify in real life whether triple therapy (fluticasone furoate / umeclidinium / vilanterol) delivered using the Ellipta device, is more effective in improving health status than triple open therapies administered with multiple dispensers. The study shows that in a population of BPCO patients representative of the daily reality of medical clinics, the combination of the three drugs administered with Ellipta significantly improved health status and lung function compared to other triple therapies taken in open label. Over 3000 patients in five European countries were followed up in the study. “The research is of great interest to those who follow patients with BPCO who need ‘triple therapy’ – explains Giovanna Elisiana Carpagnano, UOC Director of Respiratory Diseases at the Policlinico di Bari – The results at 24 weeks show that the percentage of patients ‘responders’ to the Cat (specific evaluation criterion for BPCO) was significantly higher (47%) in the group treated with the combination of the three drugs administered. with Ellipta compared to the 40% observed in the others, and that patients in the first group are 31% more likely than those treated with open label triples, delivered through multiple devices, to obtain a relevant clinical improvement in their health status “. “The results of this study are very interesting considering the importance of a correct adherence of the patient to the doctor’s indications”, af stops Angelo Corsico, director of Uoc Pneumology, Irccs Polyclinic San Matteo Foundation in Pavia. “Adherence to therapy is still one of the main challenges we face as specialists and in the field: we have effective drugs available but it is essential that the patient takes them regularly to achieve symptom control and limit the risk of BPCO exacerbations. The Intrepid study shows the importance of considering not only the drugs used in combination but also the dispenser, which must be as ‘patient-friendly’ as possible to facilitate the patient, who is often elderly, and favor optimal adherence to treatment ” . According to recent data from the Italian Committee for Adherence to Therapy (Ciat) – recalls the note Gsk – the regular intake of drugs is observed in less than 2 out of 10 patients with obstructive respiratory tract syndromes such as the BPCO. These rules are fundamental also and especially in times of Covid-19: people with BPCO are for obvious reasons at risk in case of infection with the Sars-CoV-2 virus and in May r reason a treatment correctly followed allows to improve the respiratory capacity of the patients. Unfortunately on the welfare front – according to a recent Iqvia survey – from January to December 2020, compared to the same period in 2019, 84 thousand fewer Bpco diagnoses were recorded (-25%), a decrease of 65 thousand new treatments (-23%) , 154 thousand visits to the pulmonologist (-38%) and 136 thousand requests for spirometry (-46%).