Abstract

Because of the progressive nature of chronic obstructive pulmonary disease (COPD), almost no effort is redundant to upgrade the means of its treatment. The use of fixed combinations of ultra-longand long-acting β2-agonists and anticholinergic drugs in the treatment of COPD has become increasingly widespread. This review focuses on the major principles of management of COPD, background of bronchodilation, molecular mechanisms of interactions and synergy between the bronchodilators, as well as the rationale of combining and the place for combining these two classes of drugs in the management of COPD of various degrees of severity in the context of the recently published COPD guidelines. Comparison of the available fixed combinations indacaterol/ glycopyrronium, vilanterol/umeclidinium, olodaterol/tiotropium bromide, and formoterol/ aclidinium with the monocomponents or other active comparators is reviewed in particular.