COMPARATIVE EFFICACY BETWEEN LONG-ACTING BETA-2 AGONISTS (LABA) AND LONG-ACTING MUSCARINIC ANTAGONISTS (LAMA) IN THE CLINICAL RESPONSE OF DPOC PATIENTS: A SYSTEMATIC REVIEW

Abstract

The aim of the study is to synthesize evidence on the clinical efficacy and safety of therapies with LABA and LAMA bronchodilators, alone or in combination, to guide the choice of optimal regimen in patients with COPD. A systematic review was carried out in the PubMed, ScienceDirect and Cochrane Library databases, covering publications from 2020 to 2026, using specific terms and Boolean operators. The study was governed from the PICO strategy, according to the PRISMA guidelines and with registration in the PROSPERO platform (CRD420261368419). Eleven clinical and observational studies were included, selected via Rayyan software and evaluated by the NHLBI questionnaire, presenting mostly high risk of bias. The results showed similar initial efficacy among monotherapies, but LAMA stood out in reducing previous exacerbations and tissue oxygenation. In addition, the LABA+LAMA combination showed greater clinical benefit in severe subgroups, although some evidence points to elevated cardiovascular risk. Therefore, it is concluded that both classes are fundamental, but the treatment of COPD requires a strictly individualized therapeutic choice, weighing pulmonary optimization against the cardiovascular risk profile of the patient.