Are beta-2-agonists or anticholinergics more effective for treating COPD?

Abstract

Both β2-agonists and anticholinergics appear to improve symptoms for patients with chronic obstructive pulmonary disease (COPD). Recent research indicates that adding a long-acting anti-cholinergic to a β2-agonist may improve quality of life for patients with stable COPD more than the use of β2-agonists alone. Both drug classes increase exercise capacity and alleviate symptoms of COPD, although neither alters disease progression (strength of recommendation [SOR]: A). Combination therapy can lead to greater improvements in forced expiratory volume in 1 second (FEV1) than either drug alone (SOR: A). However, until recently there were no convincing direct head-to-head comparisons of the 2 classes, and it is unclear whether this difference is clinically significant.