@article{Beeh:2016:10.1164/rccm.201609-1794CI,
author = {Beeh, KM and Burgel, P-R and Franssen, FME and Luis, Lopez-Campos J and Loukides, S and Hurst, JR and Flezar, M and Ulrik, CS and Di, Marco F and Stolz, D and Valipour, A and Casserly, B and Stallberg, B and Kostikas, K and Wedzicha, JA},
doi = {10.1164/rccm.201609-1794CI},
journal = {AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE},
pages = {139--149},
title = {How Do Dual Long-Acting Bronchodilators Prevent Exacerbations of Chronic Obstructive Pulmonary Disease?},
url = {http://dx.doi.org/10.1164/rccm.201609-1794CI},
volume = {196},
year = {2016}
}

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TY  - JOUR
AB  - Decreasing the frequency and severity of exacerbations is one of the main goals of treatment for patients with chronic obstructive pulmonary disease. Several studies have documented that long-acting bronchodilators can reduce exacerbation rate and/or severity, and others have shown that combinations of long-acting β2-adrenergic agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) provide greater reductions in exacerbation frequency than either their monocomponents or LABA/inhaled corticosteroid combinations in patients at low and high risk for these events. In this review, small groups of experts critically evaluated mechanisms potentially responsible for the increased benefit of LABA/LAMA combinations over single long-acting bronchodilators or LABA/inhaled corticosteroids in decreasing exacerbation. These included effects on lung hyperinflation and mechanical stress, inflammation, excessive mucus production with impaired mucociliary clearance, and symptom severity. The data assembled and analyzed by each group were reviewed by all authors and combined into this manuscript. Available clinical results support the possibility that effects of LABA/LAMA combinations on hyperinflation, mucociliary clearance, and symptom severity may all contribute to decreasing exacerbations. Although preclinical studies suggest LABAs and LAMAs have antiinflammatory effects, such effects have not been demonstrated yet in patients with chronic obstructive pulmonary disease.
AU  - Beeh,KM
AU  - Burgel,P-R
AU  - Franssen,FME
AU  - Luis,Lopez-Campos J
AU  - Loukides,S
AU  - Hurst,JR
AU  - Flezar,M
AU  - Ulrik,CS
AU  - Di,Marco F
AU  - Stolz,D
AU  - Valipour,A
AU  - Casserly,B
AU  - Stallberg,B
AU  - Kostikas,K
AU  - Wedzicha,JA
DO  - 10.1164/rccm.201609-1794CI
EP  - 149
PY  - 2016///
SN  - 1073-449X
SP  - 139
TI  - How Do Dual Long-Acting Bronchodilators Prevent Exacerbations of Chronic Obstructive Pulmonary Disease?
T2  - AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
UR  - http://dx.doi.org/10.1164/rccm.201609-1794CI
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000405493300010&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/51725
VL  - 196
ER  - 

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