Summary: Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory disease characterized by bronchial obstruction that leads to airway limitation. Severity assessments for COPD are established using pulmonary function tests such as FEV1 (forced expiratory volume in 1 second) and FVC (forced vital capacity) assessed by spirometry. Management options are usually established using clinical examination with TDI or MRC and the number of exacerbations. COPD treatment helps improve quality of life and reduce symptoms, the number of exacerbations and mortality. As the first choice therapy, current guidelines recommend LAMA (long-acting muscarinic antagonists) alone or with LABA (long-acting b2-agonists) and inhaled corticosteroids (ICS), depending on the severity of the disease and the history of exacerbations. In acute exacerbations, systemic corticosteroids are recommended. Several studies have discovered that ICS are prescribed in less severe COPD. LABA in combination with ICS and systemic corticosteroids improves both post dose and through FEV1 compared with placebo. The results of many randomized studies and meta-analyses suggest that LABA + LAMA better improves FEV1 compared to LABA + ICS. In spite of data indicating that corticosteroids slightly improve air flow obstruction, the rate of decline of FEV1 is not affected by therapy with inhaled or systemic corticosteroids.