---
title: "Risk Factors for COPD Exacerbations During Dual LABA/LAMA Therapy"
id: "pubmed-42741955"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42741955"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42741955/"
doi: "10.1080/07853890.2026.2722722"
published_at: "2026-09-15T12:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Risk Factors for COPD Exacerbations During Dual LABA/LAMA Therapy
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42741955
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42741955/)
- **DOI:** [10.1080/07853890.2026.2722722](https://doi.org/10.1080%2F07853890.2026.2722722)
- **Published At:** 2026-09-15T12:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This retrospective cohort study evaluated risk factors for future exacerbations among 1,076 patients with **COPD** receiving dual **LABA/LAMA** therapy. - During one year of follow-up, 284 patients (26.4%) experienced at least one exacerbation while on dual bronchodilator therapy. - Patients who exacerbated were older, had higher symptom burden (higher clinical COPD questionnaire scores), more prior-year exacerbations and hospitalizations, and a greater proportion with **GOLD grades 3–4** at baseline. - In multivariable logistic regression for the whole cohort, independent predictors of future exacerbation were **GOLD grades 3–4** (OR 1.343, 95% CI 1.016–1.776), one prior-year exacerbation (OR 1.763, 95% CI 1.248–2.489), and ≥2 prior-year exacerbations (OR 2.514, 95% CI 1.792–3.525). - In subgroup analyses by GOLD assessment groups: in group B, independent risk factors were **GOLD grades 3–4** (OR 1.808, 95% CI 1.096–2.981) and hypertension (OR 3.400, 95% CI 1.712–6.752); in group E, ≥2 prior-year exacerbations predicted future exacerbation (OR 1.426, 95% CI 1.021–1.993). - The study highlights that despite guideline-recommended dual bronchodilator therapy for groups B and E, a substantial minority remain at high risk for exacerbations, particularly those with advanced GOLD grade or recent exacerbation history. - Findings emphasize the need for clinicians to monitor patients with severe airflow limitation and prior exacerbations closely while on **LABA/LAMA** and to consider individualized management strategies. - The abstract reports study design, baseline variables collected, and one-year follow-up outcomes; additional methodological details and limitations were not reported in the provided source text.
## Clinical Analysis & Structured Key Points
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Epub 2026 Sep 15. # Risk factors for future exacerbations in patients with COPD treated with dual LABA/LAMA [Qing Song](https://pubmed.ncbi.nlm.nih.gov/?term=Song+Q&cauthor_id=42741955)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-1 "Postdoctoral Innovation Practice Base, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, People's Republic of China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-3 "Department of Pulmonary and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, China."), [Tingting Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+T&cauthor_id=42741955)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-3 "Department of Pulmonary and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, China."), [Dan Peng](https://pubmed.ncbi.nlm.nih.gov/?term=Peng+D&cauthor_id=42741955)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-4 "Department of General Medicine, The Fourth People's Hospital of Nanchang County, Nanchang, Jiangxi, China."), [Chengrui Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+C&cauthor_id=42741955)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-3 "Department of Pulmonary and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, China."), [Rensen Xiao](https://pubmed.ncbi.nlm.nih.gov/?term=Xiao+R&cauthor_id=42741955)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-3 "Department of Pulmonary and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, China."), [Qinqin Yao](https://pubmed.ncbi.nlm.nih.gov/?term=Yao+Q&cauthor_id=42741955)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-3 "Department of Pulmonary and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, China."), [Xiaoling Guo](https://pubmed.ncbi.nlm.nih.gov/?term=Guo+X&cauthor_id=42741955)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-3 "Department of Pulmonary and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, China."), [Longhua Sun](https://pubmed.ncbi.nlm.nih.gov/?term=Sun+L&cauthor_id=42741955)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-3 "Department of Pulmonary and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, China."), [Wenxin Yuan](https://pubmed.ncbi.nlm.nih.gov/?term=Yuan+W&cauthor_id=42741955)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-5 "Ultrasound Department, the First Affiliated Hospital of Nanchang University, Nanchang, China."), [Fang Huang](https://pubmed.ncbi.nlm.nih.gov/?term=Huang+F&cauthor_id=42741955)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#full-view-affiliation-3 "Department of Pulmonary and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, China.") Affiliations Expand ### Affiliations * 1 Postdoctoral Innovation Practice Base, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, People's Republic of China. * 2 Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China. * 3 Department of Pulmonary and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, China. * 4 Department of General Medicine, The Fourth People's Hospital of Nanchang County, Nanchang, Jiangxi, China. * 5 Ultrasound Department, the First Affiliated Hospital of Nanchang University, Nanchang, China. * PMID: **42741955** * DOI: [ 10.1080/07853890.2026.2722722 ](https://doi.org/10.1080/07853890.2026.2722722) Item in Clipboard # Risk factors for future exacerbations in patients with COPD treated with dual LABA/LAMA Qing Song et al. Ann Med. 2026 Dec. Show details Display options Display options Format Abstract PubMed PMID Ann Med Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Ann+Med%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Ann+Med%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42741955/) . 2026 Dec;58(1):2722722. doi: 10.1080/07853890.2026.2722722. Epub 2026 Sep 15. ### Authors [Qing Song](https://pubmed.ncbi.nlm.nih.gov/?term=Song+Q&cauthor_id=42741955)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-1 "Postdoctoral Innovation Practice Base, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, People's Republic of China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-3 "Department of Pulmonary and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, China."), [Tingting Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+T&cauthor_id=42741955)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-3 "Department of Pulmonary and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, China."), [Dan Peng](https://pubmed.ncbi.nlm.nih.gov/?term=Peng+D&cauthor_id=42741955)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-4 "Department of General Medicine, The Fourth People's Hospital of Nanchang County, Nanchang, Jiangxi, China."), [Chengrui Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+C&cauthor_id=42741955)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-3 "Department of Pulmonary and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, China."), [Rensen Xiao](https://pubmed.ncbi.nlm.nih.gov/?term=Xiao+R&cauthor_id=42741955)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-3 "Department of Pulmonary and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, China."), [Qinqin Yao](https://pubmed.ncbi.nlm.nih.gov/?term=Yao+Q&cauthor_id=42741955)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-3 "Department of Pulmonary and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, China."), [Xiaoling Guo](https://pubmed.ncbi.nlm.nih.gov/?term=Guo+X&cauthor_id=42741955)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-3 "Department of Pulmonary and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, China."), [Longhua Sun](https://pubmed.ncbi.nlm.nih.gov/?term=Sun+L&cauthor_id=42741955)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-3 "Department of Pulmonary and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, China."), [Wenxin Yuan](https://pubmed.ncbi.nlm.nih.gov/?term=Yuan+W&cauthor_id=42741955)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-5 "Ultrasound Department, the First Affiliated Hospital of Nanchang University, Nanchang, China."), [Fang Huang](https://pubmed.ncbi.nlm.nih.gov/?term=Huang+F&cauthor_id=42741955)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-2 "Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42741955/#short-view-affiliation-3 "Department of Pulmonary and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, China.") ### Affiliations * 1 Postdoctoral Innovation Practice Base, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, People's Republic of China. * 2 Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, China. * 3 Department of Pulmonary and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, China. * 4 Department of General Medicine, The Fourth People's Hospital of Nanchang County, Nanchang, Jiangxi, China. * 5 Ultrasound Department, the First Affiliated Hospital of Nanchang University, Nanchang, China. * PMID: **42741955** * DOI: [ 10.1080/07853890.2026.2722722 ](https://doi.org/10.1080/07853890.2026.2722722) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2026 report revised the combined chronic obstructive pulmonary disease (COPD) assessment. Patients in groups B and E are recommended dual long-acting β2-agonist (LABA)/long-acting muscarinic antagonist (LAMA) as the initial inhalation therapy. However, some patients still experience exacerbations during treatment. This study aimed to investigate the risk factors for future exacerbations in patients with COPD treated with dual LABA/LAMA. **Methods:** This was a retrospective cohort study. Baseline data included demographic characteristics, pulmonary function, symptom scores, GOLD grades, GOLD groups, the number of exacerbations and hospitalizations in the past year, LABA/LAMA, and comorbidities were collected. The number of future exacerbations was collected during one year of follow-up. **Results:** A total of 1076 patients with COPD were included. There were 284 (26.4%) patients experienced exacerbations during follow-up. Patients who experienced exacerbations were older and had higher clinical COPD questionnaire scores, a great number of exacerbations and hospitalizations in the past year, and a higher proportion of GOLD grades 3-4. Logistic regression analysis showed that GOLD grades 3-4 (odds ratio [OR] = 1.343, 95% confidence intervals [CI] = 1.016-1.776), one exacerbation in the past year (OR = 1.763, 95% CI = 1.248-2.489), and ≥ 2 exacerbations in the past year (OR = 2.514, 95% CI = 1.792-3.525) were independent risk factors for experiencing exacerbations. Furthermore, in group B, logistic regression analysis showed that GOLD grades 3-4 (OR = 1.808, 95% CI = 1.096-2.981) and hypertension (OR = 3.400, 95% CI = 1.712-6.752) were independent risk factors for experiencing exacerbations. In group E, logistic regression analysis showed that ≥ 2 exacerbations in the past year (OR = 1.426, 95% CI = 1.021-1.993) was an independent risk factor for experiencing exacerbations. **Conclusions:** Patients with COPD treated with LABA/LAMA remained at high risk of future exacerbations. GOLD grades 3-4 and exacerbations in the past year were associated with future exacerbations and may warrant particular attention from clinicians. **Keywords:** Chronic obstructive pulmonary disease; GOLD grades; Laba/LAMA; exacerbation. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ The treatment responses among different inhalation therapies for GOLD group E patients with chronic obstructive pulmonary disease. ](https://pubmed.ncbi.nlm.nih.gov/39977672/) Song Q, Lin L, Li T, Zhang P, Zeng Y, Deng D, Yi R, Liu D, Chen Y, Cai S
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