Abstract
Single-inhaler triple therapy (ICS/LA BA/LA MA) in asthma management: 2026 update of the Polish expert position statement
Department and Clinic of Pneumology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland
Department of General and Oncological Pulmonology, Medical University of Lodz, Poland
Department of Pneumology, Medical University of Lodz, Poland
Department of Pulmonary Diseases and Respiratory Failure with the Subunit of Noninvasive Ventilation and the Subunit of Sleep-Related Breathing Disorders, Kuyavian-Pomeranian Pulmonology Center, Bydgoszcz, Poland
2nd Department of Respiratory Medicine, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
Department of Internal Medicine, Allergy and Clinical Immunology, Medical University of Silesia, Katowice, Poland
Department of Pediatric Pulmonology and Allergology, Medical University of Warsaw, Poland
Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Poland
Division of Clinical Allergology, Pomeranian Medical University, Szczecin, Poland
Alergologia Polska – Polish Journal of Allergology 2026; 13, 2: 69–79
This document presents the 2026 update of the expert position statement issued by the Polish Society of Allergology and the Polish Respiratory Society on the use of single-inhaler triple therapy (SITT) in asthma management. It builds upon previous statements and incorporates new evidence from randomized controlled trials, real-world studies, and pharmacoeconomic analyses.
The updated recommendations reaffirm and expand the role of SITT in specific clinical scenarios, including patients with small airway disease, those at high risk of exacerbations, and patients with asthma who smoke.
Key elements of the Polish approach include the use of SITT with a medium dose of inhaled corticosteroids (ICS) at Step 4B in cases of inadequate response to Step 4A therapy (MART or ICS/LABA with a medium or high dose of ICS), and the use of SITT with a high dose of ICS at Step 5 in the majority of patients before considering biologic therapy.
The document emphasizes that treatment selection should reflect the clinical characteristics of asthma and incorporate all available therapeutic and diagnostic options. Avoiding a rigid, algorithmic approach is essential, with therapy tailored to the individual patient.
Keywords
asthma, single-inhaler triple therapy, single-inhaler triple therapy, treatment escalation, inhaled corticosteroids, long-acting muscarinic antagonist, long-acting β₂-agonists
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