What should be the next step if a patient on LABA/LAMA treatment is not obtaining relief?

A patient on a long-acting beta-agonist (LABA) and long-acting muscarinic antagonist (LAMA) treatment may not be achieving adequate relief from their symptoms for several reasons, such as poor medication adherence, disease progression, or underlying factors that are not addressed by their current regimen.

Providing a LABA/inhaled corticosteroid (ICS) combination is a well-supported next step in managing patients who remain symptomatic despite using LABA/LAMA therapy. The rationale behind this approach is that while LABAs and LAMAs improve airflow by targeting bronchoconstriction, the addition of ICS can address airway inflammation, which is a common contributor to persistent symptoms in conditions like asthma and chronic obstructive pulmonary disease (COPD).

The use of LABA/ICS combinations has been shown to improve symptom control, decrease exacerbations, and enhance overall respiratory health in many patients. This strategy allows for a more comprehensive management of the patient’s condition.

Other strategies, such as switching medications or increasing dosages of existing ones, might be appropriate in some cases, but adding an inhaled corticosteroid can directly tackle persistent inflammation that the LABA and LAMA alone may not sufficiently address. Therefore, providing a LABA/ICS