Efficacy and safety similar to the beclomethasone / formoterol + tiotropium association in separate devices.
Alternative in patients with two or more exacerbations / year, or more than one exacerbation / year requiring hospitalization, and relevant symptoms (GOLD group D), with severe obstruction to airflow and who do not respond adequately to a ICS / LABA combination, after having verified that the technique of use of the inhaler as well the adherence to the previous treatment are adequate.