The Role of Bronchodilators in Preventing Exacerbations of Chronic Obstructive Pulmonary Disease

• Published in: Tuberculosis and respiratory diseases Vol. 79; no. 4; pp. 241 - 247
• Main Author: Beeh, Kai M
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Tuberculosis and Respiratory Diseases 01-10-2016; 대한결핵및호흡기학회
• Subjects: Review; 내과학; Bronchodilators; Therapy; Pulmonary Disease, Chronic Obstructive
• ISSN: 1738-3536; 2005-6184
• DOI: 10.4046/trd.2016.79.4.241

Bronchodilators are the cornerstone of symptomatic chronic obstructive pulmonary disease (COPD) treatment. They are routinely recommended for symptom reduction, with a preference of long-acting over short-acting drugs. Bronchodilators are classified into two classes based on distinct modes of action, i.e., long-acting antimuscarinics (LAMA, once-daily and twice-daily), and long-acting β2-agonists (LABA, once-daily and twice-daily). In contrast to asthma management, evidence supports the efficacy of both classes of long-acting bronchodilators as monotherapy in preventing COPD exacerbations, with greater efficacy of LAMA drugs versus LABAs. Several novel LAMA/LABA fixed dose combination inhalers are currently approved for COPD maintenance treatment. These agents show superior symptom control to monotherapies, and some of these combinations have also demonstrated superior efficacy in exacerbation prevention versus monotherapies, or combinations of inhaled corticosteroids plus LABA. This review summarizes the current data on clinical effectiveness of bronchodilators alone or in combination to prevent exacerbations of COPD.