What therapy is required for COPD patients who experience frequent or hospitalized exacerbations?

In patients with Chronic Obstructive Pulmonary Disease (COPD) who experience frequent exacerbations or have been hospitalized due to their condition, the recommended therapy is a combination of a Long-Acting Beta Agonist (LABA) and a Long-Acting Muscarinic Antagonist (LAMA). This combination is beneficial because it provides complementary mechanisms of action that result in improved bronchodilation and overall control of symptoms.

Using both a LABA and a LAMA can significantly reduce the frequency of exacerbations, improve lung function, and enhance quality of life. The use of this combination therapy addresses both pathway of airway obstruction by targeting different receptors in the lungs. Moreover, evidence from clinical guidelines recommends this approach for patients classified as having a higher risk of exacerbations, ensuring better management of their condition and decreasing the likelihood of hospital admissions.

Monotherapy with a single bronchodilator (such as just a LABA or a LAMA alone) may not be sufficient for these patients due to the greater severity of their disease. Similarly, using an inhaled corticosteroid (ICS) alone, while helpful for certain patients, does not provide the necessary bronchodilation that patients with frequent exacerbations require. Short-acting bronchodilators