A Systematic Review With Meta-Analysis of Dual Bronchodilation With LAMA/LABA for the Treatment of Stable COPD

This review of 14 papers and 1 abstract (23,168 patients) found that all LAMA/LABA combinations were always more effective than the LAMA or LABA alone in terms of the improvement in trough FEV1. There was no significant difference among LAMA/LABA combinations.

NICE CG101 - Chronic obstructive pulmonary disease in over 16s: diagnosis and management recommends the following for patients who remain breathless or have exacerbations despite using short-acting bronchodilators as required:

• LABA or LAMA therapy where FEV≥50% predicted

• Either a LABA with an ICS in a combination inhaler, or LAMA if FEV<50% predicted

In people with stable COPD and an FEV1 ≥50% who remain breathless or have exacerbations despite maintenance therapy with a LABA, NICE CG101 recommends either a LABA+ICS combination inhaler, or a LAMA in addition to LABA where ICS is declined or not tolerated.