What do systematic reviews say?

LABA/LAMA vs LAMA

LABA/LAMA showed no clear difference in pneumonia: high‐risk population compared with LAMA (moderate certainty).

• Dual combination therapy versus long‐acting bronchodilators alone for chronic obstructive pulmonary disease (COPD): a… 2018 · Cochrane Headline outcomes only
  OR 0.98 [0.59, 1.61]
  2 studies · 2510 participants
  Moderate

LABA/LAMA vs LABA

• Dual combination therapy versus long‐acting bronchodilators alone for chronic obstructive pulmonary disease (COPD): a… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

LABA/LAMA vs LABA plus inhaled corticosteroid (ICS)

LABA/LAMA probably leads to lower pneumonia: high‐risk population compared with LABA/ICS (moderate certainty).

• Dual combination therapy versus long‐acting bronchodilators alone for chronic obstructive pulmonary disease (COPD): a… 2018 · Cochrane Headline outcomes only
  OR 0.62 [0.4, 0.96]
  1 study · 3358 participants
  Moderate