What do systematic reviews say?

LAMA vs LABA

LAMA leads to lower moderate to severe exacerbations: high‐risk population compared with LABA (high certainty).

• Dual combination therapy versus long‐acting bronchodilators alone for chronic obstructive pulmonary disease (COPD): a… 2018 · Cochrane Headline outcomes only
  OR 0.84 [0.76, 0.92]
  1 study · 7376 participants
  High

LABA/LAMA vs LAMA

LABA/LAMA showed no clear difference in moderate to severe exacerbations: 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 1.06 [0.89, 1.27]
  1 study · 2206 participants
  Moderate

LABA/LAMA vs LABA plus inhaled corticosteroid (ICS)

LABA/LAMA showed no clear difference in moderate to severe exacerbations: 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 0.87 [0.76, 1]
  1 study · 3372 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/ICS vs LAMA

LABA/ICS showed no clear difference in moderate to severe exacerbations: 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 1.12 [0.9, 1.39]
  2 studies · 1580 participants
  Moderate