Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease that involves lung parenchyma and the airways characterized by progressive airflow obstruction, reduced lung elastic recoil, hyperinflation and flow limitation, that are responsible for exertional dyspnea, reduced exercise tolerance and poor quality of life [1–3]. The pillar of the pharmacological treatment of COPD is represented by long acting inhaled anti-muscarinic (LAMA) and β2-agonists (LABA), associated with inhaled corticosteroids (ICS) in patients at high risk of acute exacerbations [4].
