*3.9. MABAs*

Bifunctional M3 receptor muscarinic antagonists/β2-adrenoceptor agonists (MABAs) are dimeric molecules that simultaneously block M3 muscarinic receptors while activating β2 receptors, and thus may be readily co-formulated with anti-inflammatory agents [81,82], simplifying dosing schedules and improving patient adherence to medication. A Phase I/II RCT [42,43] reported that in asthmatic patients, the inhaled MABA CHF6366 significantly (*p* < 0.05) improved the change from pre-dose in FEV1 on day 1 when administered at 160 μg, but not at 40 μg, 80 μg, and 240 μg, compared to the effect induced by PCB, while no difference was detected in the change from pre-dose in FEV1 on day 7; no data are available for symptoms control [42,43].
