LABA/LAMA dual bronchodilator therapy chronic obstructive pulmonary disease long-acting muscarinic antagonist long-acting β2 agonist. Conclusions: Based on the reviewed evidence, in patients with symptomatic COPD who complain of dyspnea and/or exercise intolerance, dual LABA/LAMA therapy is superior to either LABA or LAMA monotherapy based on the reduced risk of exacerbations and hospitalizations. Conclusion: Evidence supporting the efficacy of LABA/LAMA FDCs for COPD is heterogeneous, particularly for TDI and SGRQ scores, exacerbation rates, ET, and IC. LABA/LAMA combination therapy showed no difference in treatment-emergent adverse effects (risk ratio, 0.99 P = 0.34) when compared with either LAMA or LABA monotherapy. LABA/LAMA FDCs were safe, with no increase in the risk of adverse events with LABA/LAMA FDCs vs the monocomponents. Although there is reduced dyspnea (0.10 standardized mean difference P < 0.001) and improved health-related quality of life (-0.13 standardized mean difference P < 0.001), both values did not meet a clinical meaningful difference threshold. inhaler that includes a LAMA and LABA results in fewer COPD exacerbations than. Pairwise random-effects meta-analysis revealed reductions in hospital admissions (11% reduction P < 0.01) and acute exacerbations of COPD (20% reduction P < 0.002), all in favor of LABA/LAMA dual therapy. One of the fixed-dose LAMA/LABA combinations is the dry powder inhaler. Results: A total of 24 studies were eligible for inclusion ( n = 45,441). The Grading of Recommendations Assessment, Development, and Evaluation method was applied to rate the certainty and quality of the evidence. A systematic approach was used to screen, abstract, and critically appraise the emerging study evidence. Objectives: To clarify the evidence landscape, we conducted a systematic review to answer the following question: in patients with COPD who complain of dyspnea and/or exercise intolerance, is LABA/LAMA combination therapy more effective and equally safe compared with LABA or LAMA monotherapy? Methods: A search of Medline, EMBASE, and the Cochrane Library databases was conducted by a medical librarian for randomized controlled trials enrolling patients with COPD who complain of dyspnea and/or exercise intolerance that compare LABA/LAMA combination therapy to LABA or LAMA monotherapy. Long-acting β 2-receptor agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) have long been mainstays of treatment, though it is still not clear if dual therapy with LABA/LAMA is superior to monotherapy for symptomatic COPD. Rationale: There is uncertainty on the optimal first-line therapy for symptomatic chronic obstructive pulmonary disease (COPD). Recently, two 'fixed triple' single-inhaler combinations of an inhaled corticosteroid (ICS), a long-acting 2-agonist (LABA), and a long-acting muscarinic antagonist (LAMA) have become available for patients with COPD.
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