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Editorial

Novel combined candidate new hopes for COPD maintenance therapy!?

If we are looking at the last advances in the therapy of COPD we can observe that the COPD pipeline consists of more than 200 products mainly bronchodilators and on second place anti-inflammatories. The competition is open and every research department of the pharmaceuticals companies try to do his best. It's not only a competition between drug classes it is also a competition of concepts where we can see in this moment some representatives in full position such as long acting muscarinic antagonists (LAMAs) or long acting β2-adrenoceptor agonists (LABAs), but also some new inhaled steroids, even if the role of inhaled steroid for chronic treatment remains controversial and largely unresolved1,2. This new coming generations changed also the strategies and the GOLD board was obliged to take into acount and to accept for the first time in 20143 the first fixed combination of LABAs and LAMAs as an efficient therapy. The experts recommend combining bronchodilators of different pharmacological classes to improuve efficacy and decreasing the risk of side effects compared to increasing the dose of a single bronchodilator. It was a successive incoming of the new generations of combination of LABAs and LAMAs. A first indication remains the COPD patients not adequately controlled with monotherapy resulting in the development of an increasingly confusing variety of LAMA+LABA fixed-dose combinations (FDCs)1,3 and their respective generic clones.