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MediumRespiratoryChronic obstructive pulmonary diseaseca-mccqe1ca-ccfpca-rcpsc-im

A 69-year-old former smoker with GOLD stage 3 COPD (FEV1 40% predicted) has two moderate exacerbations in the past year despite treatment with a long-acting muscarinic antagonist (LAMA) alone. He uses salbutamol as needed. According to recent Canadian Thoracic Society COPD pharmacotherapy guidance, which is the most appropriate adjustment?

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