If doctors are prescribing it together they are making a mistake. Breo is a combination medication, containing a LAMA and a LABA. Spiriva is a LAMA. If you take one LAMA, you should not take another. If the docs prescribing are not pulmonologists, you need to get to a pulmonologist to find someone who knows about medications. A pharmacist should catch the error and ask the prescriber why two LAMAs are being prescribed. It isn't recommended.

Trelegy is a good controller medicine.
I take mine in the late afternoon for more coverage during sleep hours.
Used Breo + Incruse at first. Then Bevespi + Budesonide (ICS) later.

Still using Ipratropum Bromide - a SAMA. It is used in a nebulizer machine up to twice a day. Mixed with Albuterol too. Known as Duoneb. Here's the info on it:
https://en.wikipedia.org/wiki/Ipratropium_bromide
Did the research study make any sense about the harm from LAMA medications?

Thanks, and what are you using? Do you like it?

Sorry for the confusion. The only articles I found about NOT using Breo and Spiriva together actually came from posts in this Forum. Then you have to "consider the source".
Using these two together is actually common to achieve the "three-in-one" treatment from brands like Trelegy or Breztri. These are more common at the advanced stages of our condition. (You can click on any of these medicine names that are blue in color to get more information about them.)
IF more than two of your meds had LAMA-type ingredients in them your pharmacist would see a red flag in filling the prescription. So would the Insurance company!
The LAMA ingredients are troublesome but not for the reason we are told. The problem is they do not just act on Lung problems alone. They travel through the body and nervous system, affecting other organs. And creating new problems too.
You've trusted Google thus far. Take a look at the issues about LAMAs here:
https://www.tandfonline.com/doi/full/10.1185/03...
Be well

Which strength? Do you use any oxygen?