For COPD patients in Group B, which combination is considered first-line therapy?

For patients with COPD classified in Group B, the preferred first-line therapy is a long-acting beta-agonist (LABA) combined with a long-acting muscarinic antagonist (LAMA). This combination is recommended due to its efficacy in improving lung function and reducing symptoms.

Patients in Group B typically experience more symptoms but have a lower level of exacerbations compared to those in Group D. The inhalation of both a LABA and a LAMA works by providing complementary mechanisms of action; LABAs help relax the muscle bands that tighten around the airways, while LAMAs block the action of acetylcholine at muscarinic receptors, resulting in further airway dilation. This dual approach has shown to enhance patients' quality of life and reduce the frequency of exacerbations more effectively than using a single long-acting bronchodilator alone.

Other options, such as combining a LAMA with a short-acting muscarinic antagonist (SAMA) or relying solely on a short-acting bronchodilator, are not optimal for patients in Group B, as these do not provide the sustained bronchodilation and symptom control necessary for this group. The single long-acting bronchodilator does not offer the enhanced benefit that the combination therapy