A related commentary discusses this research. This study is important as it is the first to address the gap in understanding regarding triple therapy versus double therapy for preventing COPD exacerbations. Limitations however exist. It is important to remember that the patients enrolled in this study were at the most severe end of the COPD spectrum since they had severe or very severe airflow limitation (forced expiratory volume in 1 s <50% of reference), were symptomatic at screening despite treatment (COPD Assessment Test score ≥10), and had experienced at least one documented moderate or severe COPD exacerbation in the previous year. This means that the results of this study only apply to this specific population of patients and cannot be generalised to other patients with milder COPD. The results however help better position triple therapy in a single inhaler within the clinical management of COPD. It will be of great interest to compare these results with those of a similar study, (IMPACT) that is likely to be published soon.