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The randomised controlled trial (GLISTEN) by Frith et al1 showed significant improvements in trough FEV1, health-related quality of life and rescue medication when long-acting muscarinic antagonists (LAMA: as either tiotropium or glycopyrronium) were added to inhaled corticosteroid/long-acting beta-agonist (ICS/LABA: as fluticasone/salmeterol) in 773 patients with moderate-to-severe COPD (FEV1 57.2%) over 12 weeks. The authors concluded that this was the first …