The Role of Fixed-Dose Dual Bronchodilator Therapy in Treating COPD

Antonio Anzueto, Marc Miravitlles

Research output: Contribution to journalReview articlepeer-review

22 Scopus citations


The incidence of chronic obstructive pulmonary disease (COPD) is rising in the United States, and the disease represents a significant source of morbidity and mortality. Primary care providers face many challenges in COPD diagnosis and treatment, as different clinical phenotypes require personalized treatment approaches. Patient adherence and inhaler technique also contribute to treatment outcomes. Around 48% of primary care providers are unaware of guidelines and recommendations for COPD diagnosis and treatment, which may lead to misdiagnosis or undertreatment of COPD symptoms. Inadequately treated COPD can impair patients' quality of life and ability to perform everyday activities. Long-acting bronchodilator therapy is the cornerstone treatment for patients with COPD; combinations of bronchodilators of different pharmacological classes have shown improved efficacy vs monotherapy. We review the rationale behind fixed-dose dual bronchodilator therapy, evidence for the 4 currently Food and Drug Administration-approved long-acting anticholinergic bronchodilators/long-acting β2-agonists fixed combinations, patient suitability for the available inhaler devices, and practical guidance to optimize personalized care for patients with COPD.

Original languageEnglish (US)
Pages (from-to)608-622
Number of pages15
JournalAmerican Journal of Medicine
Issue number6
StatePublished - Jun 2018


  • Bronchodilation
  • COPD
  • LABA
  • LAMA

ASJC Scopus subject areas

  • General Medicine


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