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MediumRespiratoryChronic obstructive pulmonary diseaseau-amcau-racgpau-racp

A 70-year-old ex-smoker presents with exertional dyspnoea and chronic cough productive of sputum. Spirometry shows FEV₁/FVC ratio 0.55 and FEV₁ 45% predicted. He has had two exacerbations needing oral steroids and antibiotics in the past year. According to the COPD-X recommendations, which of the following is the most appropriate maintenance pharmacotherapy?

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