A Long-Acting Muscarinic Antagonist Is an Effective Add-On Agent for Uncontrolled COPD

For patients with chronic obstructive pulmonary disease (COPD) at risk for exacerbation, the 2016 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines recommend either the combination of a long-acting β-agonist (LABA) plus an inhaled glucocorticoid (ICS) or monotherapy with a long-acting muscarinic antagonist (LAMA). Although some studies have shown that ICS use is associated with fewer exacerbations (especially in patients with eosinophilia or COPD/asthma overlap syndrome), it might be associated with excess risk for pneumonia. Researchers examined whether adding a LABA to a LAMA is as effective at preventing exacerbations as is a LABA/ICS combination.

In an industry-funded, international study, 3362 patients with COPD a…