Use of Biologics in Asthma with Beclometasone/Formoterol/Glycopyrronium: First Key Results from TriMaximize Study

Background: Inhaled triple therapy remains underutilized in asthma management, likely due to concerns about using multiple inhaler devices and potential challenges with patient adherence. Although the efficacy of fixed triple therapy with beclometasone dipropionate/formoterol fumarate/glycopyrronium (BDP/FF/G) in reducing exacerbation rates and improving lung function are well established, the use into day-to-day clinical practice has not been thoroughly investigated. TriMaximize study was designed to observe the therapy pathways and the characteristics of the patients who have initiated BDP/FF/G treatment. Methods : TriMaximize is a multinational, observational study following asthma patients prescribed BDP/FF/G over one to three years. Patients were recruited at 165 sites across Germany, United Kingdom, Austria, Denmark, France, Spain, Poland and Italy. Descriptive analyses were performed. Results: In total, 1 445 patients (62.8% female; mean age: 57.6 years) were included in the study. The majority (72.7%) had previously been treated with ICS/LABA (open or fixed) and 27.3% with ICS/LABA/LAMA (open or fixed). At baseline, 85.3% of patients were classified as GINA step 4 and 14.7% as step 5. The mean time since asthma diagnosis was 13.6 years. In the 12 months prior initiation of BDP/FF/G therapy, 2.5% of patients had received biologics for asthma-related indications, and 1.9% for other comorbidities. During the three-year treatment with BDP/FF/G, 3.7% of patients received biologics. Among the 186 patients who discontinued BDP/FF/G therapy for any reason after three years, only 3 patients (1.6%) transitioned to biologic therapy. Conclusions: In this cohort, patients who transitioned from dual or triple inhaled therapy to extrafine BDP/FF/G therapy were rarely co-prescribed biologics. Furthermore, the initiation of biologic therapy following discontinuation of BDP/FF/G was infrequent, suggesting that this therapeutic strategy allows sufficient asthma control. Publication History Article published online: 04 March 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany