Dual bronchodilators such as Anoro or Stiolto improve lung function and decrease COPD exacerbations and have good formulary coverage. Patients with Class B or E need a dual bronchodilator as per GOLD guidelines.

Consensus seems to be that dial bronchodilator therapy can further reduce COPD symptoms and improve quality of life, and may be within reach as insurances come on board with sufficient coverage

I'd say it might have synergistic effects.

Some people are using LAMA/LABA as first line or as step down from the triple therapy. THere's not much question the dual mechanism works better.

Using multiple bronchodilators with different mechanism of action can improve symptomatic patients with COPD furthan than one inhaled bronchodilator alone. My patient have great results with ICS/LAMA INHALERS

COPD is a lung disease that makes it hard to breathe because the airways become narrowed.
using two different bronchodilators together helps people with COPD breathe better, stay more active, and feel better than using just one bronchodila

I mostly use LAMA/LABA medication as first line for COPD patients. It is definitely more effective than monotherapy and less side effects that ICS. Also, it is becoming more preferred in insurance formularies with lower out pocket expense to patients. LAMA/LABA also has a role to play in more resistant forms of asthma