Combined β-Agonist and Anticholinergic Therapy for COPD

The American Thoracic Society recommends using both β-agonists and the anticholinergic agent ipratropium to treat COPD patients with daily symptoms. Currently, patients adhering to this strategy must use two separate inhalers. This multisite, double-blind study compared a combined albuterol-ipratropium metered dose inhaler and a standard albuterol MDI.

Patients with COPD were eligible if they were at least 40 years old and had a smoking history of at least 10 pack-years; 356 patients completed the study. Improvement in FEV₁ measured on days 1 and 29 was greater in the combination drug group, especially during the first 4 hours. This group also had significant decreases in wheezing, shortness of breath, and chest tightness. The incidence of s…