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MediumRespiratory MedicineCOPD step-up therapyukmlamrcgp aktpaneprescribing safety assessment

A 67-year-old man with COPD (FEV₁ 45% predicted) has frequent exacerbations (3 in the last year) despite a LAMA. He has blood eosinophils 0.35×10⁹/L. What is the next inhaled therapy step?

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