Using a LABA in combination with a LAMA rather than an inhaled corticosteroid to treat COPD is more effective in preventing exacerbations, according to a study.

Patients receiving a combination of indacterol-glycopyrronium experienced 11% fewer exacerbations over the year than patients taking salmeterol-fluticasone.

The indacterol-glycopyrronium group also experienced a significantly longer time to their first COPD exacerbation – 71 days versus 51 – and a 17% reduction in the rate of moderate or severe exacerbations.

Pneumonia incidence was also significantly lower in the group LABA-LAMA group – at 3.2% compared to 4.8% in patients taking salmeterol-fluticasone.

The team conducted a double-blind randomised trial comparing indacterol-glycopyrronium – a LABA-LAMA combination – with a LAMA and inhaled corticosteroid combination in salmeterol-fluticasone to assess the effect of each combination on the number of COPD exacerbations over the course of a year.

Current NICE guidelines recommend GPs offer a LABA with either an inhaled corticosteroid or a LAMA to patients who are breathless or suffer exacerbations despite using a SABA, and who have an FEV1 <50%.

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