 The foundation of COPD therapy is to combine inhaled therapy to optimize benefits as it was done several years ago by associating short-acting β2-agonists and muscarinic antagonist. The recent availability of once-daily LABALAMA fixed combination products makes this therapeutic strategy even more appealing and appears as a promising treatment option in COPD. One relevant question regarding these new LABALAMA combinations is whether they provide superior benefits compared to a single agent. Once-daily LABALAMA fixed combinations consistently improves lung function compared to monotherapy. The key question is whether they provide superior efficacy to monotherapy on patients oriented clinical outcomes, beyond lung function improvement. In regards, once-daily LABALAMA fixed combinations can reduce exacerbation rate and perception of dyspnea, further to what can be obtained with the monocomponents. Once-daily LABALAMA fixed combinations also improve exercise tolerance compared to placebo but whether they provide additional benefit over monotherapy is uncertain. 