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Choosing an initial maintenance therapy for COPD patients

LAMA/LABAs are indicated as maintenance bronchodilator treatments to relieve symptoms in adult patients with COPD.

What does NICE recommend?

NICE updated its COPD guideline (in Dec 2018) to recommend a LAMA/LABA as initial maintenance therapy in patients with no asthmatic features/features suggesting steroid responsiveness who remain breathless/have exacerbations despite short acting bronchodilator therapy.1

According to the guidance, such patients should have spirometrically confirmed COPD as well as have been offered/received treatment for tobacco dependence (if smokers), had optimised non-pharmacological management and received relevant vaccinations.1

3 key reasons:

The NICE guidelines state that ‘the evidence showed that, compared with other dual therapy combinations and monotherapy, LAMA+LABA’:1

  • ‘provides the greatest benefit to overall quality of life’1
  • ‘is better than other inhaled treatments for many individual outcomes…’1
  • ‘is the most cost effective option’1

© NICE 2019 Chronic obstructive pulmonary disease in over 16s: non-pharmacological management and use of inhaled therapies. Available from All rights reserved. Subject to Notice of rights. NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication. For more information on the NICE COPD guidelines see

Hear it from the experts

GSK organised and funded a roundtable meeting with respiratory experts to discuss the health-system impact of LAMA/LABA initial maintenance therapy (IMT) in COPD. Attendees were paid an honorarium for their time by GSK. Watch the video to understand why you might want to consider LAMA/LABA IMT in specific COPD patients.

Which LAMA/LABA will you choose?

There are many LAMA/LABAs to consider using as initial maintenance therapy, but not all are the same.

AnoroEllipta (umeclidinium/vilanterol) is the only LAMA/LABA with head-to-head data vs tiotropium HandiHaler (LAMA) and vs Spiolto Respimat (LAMA/LABA).2-6

Explore the differences and discover more about Anoro now.

Anoro is indicated as a maintenance bronchodilator treatment to relieve symptoms in adult patients with COPD.

AnoroEllipta (umeclidinium/vilanterol): prescribing information
IncruseEllipta (umeclidinium): prescribing information
Serevent (salmeterol): prescribing information
Ventolin (salbutamol): prescribing information

Adverse events should be reported. Reporting forms and information can be found
at or search for MHRA Yellow card in the Google Play or Apple App store.
Adverse events should also be reported to GlaxoSmithKline on 0800 221 441.



  1. COPD in over 16s: diagnosis and management NICE guideline [NG115] Published date: July 2019. Accessed: June 2020.
  2. Anoro Ellipta SmPC
  3. Maleki-Yazdi M et al. Adv Ther 2016; 33:2188–2199
  4. Feldman GJ et al. Adv Ther 2017; 34:2518–2533
  5. Decramer M., et al. Lancet Respir Med 2014; 2:472–86
  6. Maleki-Yazdi MR., et al. Respir Med 2014; 108:1752–60

PM-GB-UCV-WCNT-200008 V2.0 | August 2020

© 2020 GSK Group of Companies or its licensor. Trademarks are the property of their respective owners.
Anoro Ellipta was developed in collaboration with Innoviva.