The management of symptoms of chronic obstructive pulmonary disease (COPD) typically involves the use of inhaled long-acting bronchodilators. Previously, we have reviewed the long-acting muscarinic antagonists (LAMAs) ▼aclidinium,1 ▼glycopyrronium,2 tiotropium3 and ▼umeclidinium,4 and the long-acting beta2 agonists (LABAs) indacaterol,5 ▼olodaterol,6 and ▼vilanterol (in combination with fluticasone) in the management of COPD.7 Four fixed-dose combinations of a LAMA with a LABA are now available, all indicated as maintenance bronchodilator treatment to relieve symptoms in adult patients with COPD. Here, we provide a brief overview of the four combinations and consider the place of a LAMA/LABA in people with COPD and any factors that might help to choose between them.
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