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[Comment] COPD therapy: if two is good, is three better?

Drug therapy for chronic obstructive pulmonary disease (COPD) is simple in principle. Treatment aims to maximise airway calibre and open closed airways to promote lung deflation at rest and during exercise. Additionally, the risk of exacerbations should be minimised either by improved lung mechanics, decreasing the burden of airway pathogens, or reducing the chronic inflammation that characterises COPD. The principles might be clear but the practice has become complex with a plethora of similar drugs delivered alone or in combination once or twice daily.