Current evidence for COPD management with dual long-acting muscarinic antagonist/long-acting β2-agonist bronchodilators.

Current evidence for COPD management with dual long-acting muscarinic antagonist/long-acting β2-agonist bronchodilators. Postgrad Med. 2020 Jan 03;:1-8 Authors: Skolnik NS, Nguyen TS, Shrestha A, Ray R, Corbridge TC, Brunton SA Abstract Long-acting inhaled bronchodilator medications are recommended as initial maintenance therapy for many patients with COPD. These medications include long-acting muscarinic antagonists (LAMA) and long-acting β2-agonists (LABA). Combinations of long-acting bronchodilator agents (LAMA/LABA) and inhaled corticosteroids combined with LABA (ICS/LABA) are also used as initial or follow-up therapy in patients with more severe symptoms or at risk of COPD exacerbations. This review summarizes the position of LAMA/LABA combinations in treatment recommendations, and the evidence supporting their placement relative to LAMA monotherapy and ICS/LABA combination therapy, as well as differences within the LAMA/LABA class. Most studies show that LAMA/LABA treatment leads to greater improvements in lung function and symptoms than LAMA monotherapy or ICS/LABA treatment. There are fewer studies comparing the impact of different medication classes on patients' risk of exacerbations; however, the available evidence suggests that LAMA/LABA treatment and LAMA monotherapy lead to a similar reduction in exacerbation risk, while the effect of LAMA/LABA compared with ICS/LABA remains unclear. The incidence of adverse events is ...
Source: Postgraduate Medicine - Category: Internal Medicine Tags: Postgrad Med Source Type: research