title: Efficacy and safety of LABA/LAMA fixed-dose combinations approved in the US for the management of COPD.
abstract: Long-acting β2-agonists [LABAs] and long-acting muscarinic antagonists [LAMAs]) are primary therapies for chronic obstructive pulmonary disease (COPD). Despite improvements in lung function and patient-reported outcomes (PROs) with these therapies, there is room to optimize outcomes further. Combined use of LABAs and LAMAs is recommended when symptoms are not improved with a single agent, and LABA/LAMA fixed-dose combinations (FDCs) are at the forefront of drug development in COPD.
  
  
  
  This review focusses on the three LABA/LAMA FDCs (indacaterol/glycopyrrolate(1) [IND/GLY] 27.5/15.6 µg twice daily, umeclidinium/vilanterol [UMEC/VI] 62.5/25 µg once daily and tiotropium/olodaterol [Tio/Olo] 5/5 µg once daily approved in the US. Phase III clinical trials have shown benefits in lung function, dyspnea and health status with FDCs of IND/GLY, UMEC/VI and Tio/Olo versus placebo and monotherapies. Expert commentary: Data from recent studies of three LABA/LAMA combinations, reviewed here, indicate that dual bronchodilation may be beneficial above and beyond both the monotherapies and LABA/ICS combinations, in providing improvements in lung function and PROs for patients with COPD, which may encourage a shift away from the use of ICS in COPD management, in particular for non-exacerbating patients.
authors.affiliation: a Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA.
authors.forename: Donald
authors.initials: D
authors.lastname: Banerji
authors.affiliation: b Geisel School of Medicine at Dartmouth , Hanover , NH , USA.|c Valley Regional Hospital , Hanover , NH , USA.
authors.forename: Donald A
authors.initials: DA
authors.lastname: Mahler
authors.affiliation: d Section of Pulmonary and Critical Care Medicine, Asthma and COPD Clinical Research Center , Baylor College of Medicine , Houston , TX , USA.
authors.forename: Nicola A
authors.initials: NA
authors.lastname: Hanania
mesh_terms: D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use*; D004338:Drug Combinations; D006801:Humans; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists; D004338:Drug Combinations; D018727:Muscarinic Antagonists
keywords: Dyspnea; St George’s Respiratory Questionnaire; Transition Dyspnea Index; health status; indacaterol/glycopyrrolate; long-acting β2-agonist/long-acting muscarinic antagonist; lung function; safety; tiotropium/olodaterol; umeclidinium/vilanterol