Abstract
Appropriate pharmacological management of COPD (chronic obstructive lung disease) involves treatment with inhaled bronchodilators to reduce airflow limitation and hyperinflation. Most patient groups identified by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy can be managed using long-acting inhaled bronchodilators (long-acting muscarinic antagonists [LAMAs] and long-acting β2-agonists [LABAs]), with or without inhaled corticosteroids.
Fixed dose combinations (FDCs) provide potent bronchodilation versus single agents, with some advantage in terms of convenience and simplicity compared with combinations administered via separate inhalers. Beta agonists (BAs) and muscarinic antagonists (MAs) target different pathways to promote smoothmuscle relaxation and inhibit pulmonary constriction.
Combining bronchodilators with different modes of action appears to be additive, providing greater efficacy versus component monotherapies. Randomized controlled trials (RCTs) of LABA-LAMA combinations have shown improved lung function.