@alicebrew1 HI, I'm not sure what especially concerns you, and what condition you have that Trelegy is meant to treat.
Most combination inhalers are prescribed to people with progressive lung diseases like COPD, or chronic conditions like asthma that have not responded to more conservative measures. They are generally meant to be used long-term, and your doctor should consider possible interference with other medications and your other health conditions before prescribing it.

There is an increased risk of pneumonia (about 2-3%) for some people, but there is also a decreased risk of other exacerbations - so a balancing act.
People who have heart or kidney disease, osteoporosis, diabetes or hypertension or are on antibiotic therapy need to work with their doctor to determine if the benefit of better lung function outweighs the risks of long-term inhaled corticosteroids, and probably need extra monitoring. This will very from person to person.

@alicebrew1 I used to use Trelegy and when I was at NJH for BE and MABC, the ID Dr and Pulm told me they would like to see me get off it since I got off them once before and due to inhaled corticoids inhibiting the lung immune system. With BE, there is a higher risk of NTM infections with inhaled steroid use. Years ago, I was diagnosed with reactive airway disease (at NJH) and later with asthma (by local Pulm)-which may or may not have been confused with BE. NJH recently retested me for asthma (NOx and methyl choline challenge) and results were negative for asthma. The Pulm there recommended Anoro. Unfortunately, my insurance doesn't cover Anoro, so my local Pulm put me on AirSupra which is short acting, about 4-6 hours. Though, I have now been able to reduce my use of the AirSupra, I would still like to eliminate inhaled steroids completely. My local Pulm has suggested I try Brinsupri to help with the inflammation-among other things, but I'm wondering if that too could reduce immunity in the lungs. I don't know, so interested if that topic has come up.