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MediumRespiratoryChronic obstructive pulmonary diseaseau-amcau-racgpau-racp

A 55-year-old man with a 30-pack-year smoking history and chronic productive cough has spirometry showing FEV1/FVC ratio 0.55 post-bronchodilator and FEV1 55% predicted. He has two moderate exacerbations per year requiring prednisolone but no hospital admissions. According to COPD management guidelines, what is the most appropriate inhaled maintenance therapy?

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