Approximately 30 million Americans live with COPD (chronic obstructive pulmonary disease), which includes chronic bronchitis and emphysema. It’s a major cause of death and disability in the United States. Treatment cannot cure the disease; rather, treatment focuses on managing symptoms and limiting further lung damage. In the last five years or so, there have been advances in COPD treatment that make it more convenient. COPD Medication Classes If you have COPD, you probably have maintenance medicines and quick-relief medicines. Maintenance medicines are the ones you use regularly to control symptoms and flares. Quick-relief medicines treat worsening symptoms. Maintenance COPD Drugs Classes of maintenance COPD drugs include: Inhaled corticosteroids, such as budesonide (Pulmicort, Pulmicort Flexhaler) Long-acting beta agonists (LABAs), such as salmeterol (Serevent) Long-acting muscarinic antagonists (LAMAs), such as tiotropium (Spiriva) Oral PDE4 inhibitors, such as roflumilast (Daliresp) Quick-Relief COPD Drugs Classes of quick-relief COPD drugs include: Short-acting anticholinergics, such as ipratropium (Atrovent, Atrovent HFA) Short-acting beta agonists (SABAs), such as albuterol (Accuneb, Proventil HFA, Ventolin HFA, and others) None of these classes are new, although some have been around for only a few years. However, within the LABA class, olodaterol (Striverdi Respimat) and indacaterol (Arcapta Neohaler) are relatively new medications. They are ultra long-acting beta agonists with once daily dosing. This is an advantage over other LABA drugs that typically have twice daily dosing. Another similar ultra LABA, vilanterol, is only available in combination products. There are also new medicines in the LAMA class. Aclidinium (Tudorza), umeclidinium (Incruse Ellipta), and glycopyrrolate (Seebri Neohaler) are relatively recent additions to the class. In early 2018, the first nebulized LAMA became available under the brand name Lonhala Magnair. This was an important advancement for those who struggle to use inhalers. Until this approval, LABAs were the only option for nebulized long-acting bronchodilators. Combination COPD Medicines Combination products for COPD have also been around for a while. Some, such as budensonide/fomoterol (Symbicort), have been around for many years. Symbicort combines an inhaled corticosteroid and a LABA. There are several combinations of these two types of drugs. They have been a staple of COPD treatment. Until recently, they were the main type of combination product available for COPD. Current treatment guidelines recommend adding a second long-acting bronchodilator for many people with persistent COPD symptoms. Research has shown combining LAMAs and LABAs improves lung function more than either by itself. The combination may also reduce the use of quick-relief inhalers and improve quality of life. People using the combination may even have fewer COPD flares. Plus, there may be fewer side effects when combining two drugs instead of increasing the dose of one drug. Recently, new products combining LAMA and LABA bronchodilator medications to open airways include: Indacaterol/glycopyrrolate (Utibron Neohaler) Tiotropium/olodaterol (Stiolto Respimat) Umeclidinium/vilanterol (Anoro Ellipta) Fluticasone/umeclidinium/vilanterol (Trelegy Ellipta), which adds an inhaled corticosteroid to the combination of a LAMA and a LABA. Another name for this type of combination medicine is triple therapy inhaler or single inhaler triple therapy because it contains three active ingredients. These combination products allow convenient once daily dosing of your inhaled maintenance medicines. As research continues, new medicines and updated guidelines will be available. However, the severity of your COPD and your risk of exacerbations can influence your treatment choices. Talk with your doctor to understand how the most up-to-date information applies to you.