| Role in therapy: Focusing first on long-acting bronchodilators, their role in
therapy is fundamental, since these drugs, by relaxing airway smooth muscle,
determine a decrease of airway obstruction, improving lungs emptying,
exercise performance, and reducing lungs hyperinflation at rest and during
exercise, thus being now recommended as the mainstay of COPD management.
However, they do not stop the progression of disease.4
Short-acting bronchodilators are taken on an as-needed basis, as already seen
for asthma management. Inhaled formulations are preferred also in COPD
treatment, because of the higher bioavailability in the lungs and the lower risk
of side effects. With regard to the efficacy of bronchodilators, all categories
demonstrated to increase exercise capacity in COPD, without necessarily producing significant changes in FEV1.
The most important long-acting bronchodilators used in COPD management are:
- Long-acting β2-agonists (LABAs)
- Long-acting muscarinic antagonists (LAMAs)
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