Respirology : official journal of the Asian Pacific Society of Respirology
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Chronic obstructive pulmonary disease (COPD) is a leading cause of death and disability. There is now a better understanding of the pathophysiology of COPD and of the effectiveness of various treatment strategies in controlling symptoms and progression of disease. Although cessation of smoking is of primary importance, the growing realization in recent years that airflow limitation in COPD can be significantly relieved with the use of bronchodilators has changed the clinical approach to treating this disease. ⋯ The use of the combination of these two classes of inhaled bronchodilators provides superior bronchodilation than treatment with either of the individual components without added side-effects or loss of the positive effects of ipratropium bromide including reduced exacerbation frequency and lack of tachyphylaxis. The use of combination therapy also improves cost-effectiveness and patient compliance. Combination therapy should be considered as an important component of a treatment algorithm of COPD.