Inhaled fixed-dose combinations (FDCs) of a long-acting β-agonist (LABA) and a long-acting
muscarinic antagonist (LAMA) have become the cornerstone for the maintenance treatment of symptomatic
COPD patients. In this regard, global
COPD treatment guidelines have recognized the importance of
inhaler devices as integral contributors to the effectiveness of LABA/LAMA FDCs and recommend regular assessment of
inhaler device use by the patients in order to improve long-term clinical outcomes. Optimal disease control is also highly dependent upon patient preferences and adherence to
inhaler devices. This review objectively examines and compares the major
inhaler devices used to deliver different LABA/LAMA FDCs, discusses the
inhaler device characteristics that determine drug deposition in the airways, real-life preference for
inhaler devices, and handling of
inhaler devices that impact the results of the long-term management of
COPD. The introduction of new LABA/LAMA FDCs, new
inhaler devices, and more clinical studies have created
confusion among physicians in choosing the optimal inhaled
therapy for
COPD patients; in this context, this review attempts to provide an evidence-based framework for informed decision-making with a particular focus on the
inhaler devices.Funding. The preparation of this manuscript was funded by Novartis Pharma AG.