The cornerstones of treatment are bronchodilator drugs of two different classes: beta agonists and muscarinic antagonists. Great efforts were spent in the development of drugs able to improve symptoms, quality of life, reduce exacerbations, hospitalizations and the frequency of death of patients with COPD. doi: 10.1080/ obstructive pulmonary disease (COPD) is a common disabling disease characterized by progressive airflow obstruction. Sedentary Behaviour and Physical Inactivity in Patients with Chronic Obstructive Pulmonary Disease: Two Sides of the Same Coin? COPD. Schneider L.P., Furlanetto K.C., Rodrigues A., Lopes J.R., Hernandes N.A., Pitta F. Daily Impact of COPD in Younger and Older Adults: Global Online Survey Results from over 1300 Patients. Activity-related dyspnea in chronic obstructive pulmonary disease: Physical and psychological consequences, unmet needs, and future directions. Global Initiative for Chronic Obstructive Lung Disease Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: 2022 Report. Michael Dreher received speaker fees from Actelion, Astra Zeneca, Bayer, Berlin Chemie, Boehringer, Chiesi, GSK, Janssen-Cilag, Hamilton, Heinen und Lö wenstein, Intermune, Linde, Novartis, Pfizer, Philips Respironics, ResMed, Roche, Weinmann consulting fees from Almirall, Astra Zeneca, Boehringer, Chiesi, GSK, Hamilton, Janssen-Cilag, Linde, Novartis, Pfizer, Philips Respironics, ResMed and Roche and research grants from Linde, Philips Respironics and ResMed.
Tomotaka Kawayama received grants from Novartis and lecture fees from AstraZeneca, GlaxoSmithKline (GSK), Boehringer Ingelheim, Novartis, Teijin Home Healthcare, Sanofi, Kyorin and MeijiSaika Pharma. Marc Miravitlles has received speaker fees from AstraZeneca, Boehringer Ingelheim, Chiesi, Cipla, Menarini, Rovi, Bial, Kamada, Sandoz, Zambon, CSL Behring, Grifols and Novartis consulting fees from AstraZeneca, Atriva Therapeutics, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Bial, Gebro Pharma, CSL Behring, Inhibrx, Laboratorios Esteve, Ferrer, Mereo Biopharma, Verona Pharma, Spin Therapeutics, ONO Pharma, pH Pharma, Palobiofarma SL, Takeda, Novartis, Sanofi and Grifols and research grants from Grifols. This article reviews global and regional/national guideline recommendations for the use of LABA/LAMA in COPD, examines the evidence for the effectiveness and safety of LABA/LAMA versus other therapies and offers a practical guide for clinicians to help ensure appropriate use of LABA/LAMA therapy.ĬOPD LABA/LAMA bronchodilator inhaled corticosteroid. However, despite consistent guideline recommendations, real-world prescribing data indicate that LAMA and/or LABA without an inhaled corticosteroid are not the most widely prescribed therapies in COPD. The recommendations for LABA/LAMA are broader in the American Thoracic Society treatment guidelines, which strongly recommend LABA/LAMA combination therapy over LAMA or LABA monotherapy in patients with COPD and dyspnea or exercise intolerance. The Global Initiative for Chronic Obstructive Lung Disease 2022 report recommends initial pharmacological treatment with a long-acting muscarinic antagonist (LAMA) or a long-acting β 2-agonist (LABA) as monotherapy for most patients, or dual bronchodilator therapy (LABA/LAMA) in patients with more severe symptoms, regardless of exacerbation history. Inhaled bronchodilators (alone or in combination) are the cornerstone of treatment for symptomatic patients with COPD, either as initial/first-line treatment or for second-line/treatment escalation in patients who experience persistent symptoms or exacerbations on monotherapy.
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