{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T15:28:48Z","timestamp":1788276528933,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82130001"],"award-info":[{"award-number":["82130001"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2024YFC3044400"],"award-info":[{"award-number":["2024YFC3044400"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Chronic obstructive pulmonary disease (COPD) is characterized by irreversible airflow limitation. While single\u2010inhaler long\u2010acting dual bronchodilators (LADBs) effectively relieve symptoms and improve lung function, their long\u2010term impact on spirometry outcomes and the potential for meaningful changes in key diagnostic indices in a real\u2010world setting remain underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a single\u2010country (China), single\u2010center, retrospective, noninterventional, real\u2010world study that included 182 patients treated with LADBs (indacaterol\/glycopyrronium [IND\/GLY] or umeclidinium\/vilanterol [UMEC\/VI]). The primary outcomes were changes in trough FEV1 and FEV1\/FVC from baseline. Secondary outcomes were changes in other spirometry parameters. An exploratory post hoc analysis explored the reversal of FEV1\/FVC, defined as a posttreatment trough FEV1\/FVC ratio that exceeded 70%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Single\u2010inhaler LADB therapy significantly improved lung function, including FEV1, FVC, FEV1\/FVC, RV, and parameters of small airway function. The least\u2010square mean change in trough FEV1 and FEV1\/FVC post\u2010treatment was 0.154\u2009L [95% CI: 0.09, 0.218] and 1.929% [95% CI: 0.694, 3.164], respectively, at 24\u2009weeks. Posttreatment FEV1 exhibited a characteristic pattern: an initial increase, followed by a peak, a subsequent slight decline, and eventual stabilization. Patients with lower GOLD grades experienced greater improvement in key spirometry parameters. Notably, 21 patients (11.5%) achieved a reversal of the FEV1\/FVC ratio to over 70%. Exploratory logistic regression showed that a better baseline lung function, especially FEV1\/FVC ratio, was associated with an increased likelihood of achieving this threshold (OR\u2009=\u20091.52 [95% CI: 1.29, 1.89]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrated significant and sustained improvements in lung function in this real\u2010world cohort of COPD patients managed with LABA\/LAMA monotherapy. A subset of patients achieved a posttreatment FEV1\/FVC ratio above 70%, indicating a potentially meaningful change in airflow limitation after LADB therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/crj.70173","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T06:27:33Z","timestamp":1776752853000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Temporal and Partial Reversal of Airflow Limitation in Patients With COPD Treated With Single\u2010Inhaler Long\u2010Acting Dual Bronchodilators"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0167-5172","authenticated-orcid":false,"given":"Yimeng","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Shanghai Medical College Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8236-1789","authenticated-orcid":false,"given":"Yanan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Shanghai Medical College Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Shanghai Medical College Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Shanghai Medical College Fudan University  Shanghai 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Critical Care Medicine, Zhongshan Hospital, Shanghai Medical College Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuicui","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Shanghai Medical College Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linlin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Shanghai Medical College Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanlin","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Shanghai Medical College Fudan University  Shanghai China"},{"name":"Shanghai Key Laboratory of Lung Inflammation and Injury, Department of Pulmonary 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