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EasyRespiratoryStable COPD initial pharmacotherapyca-mccqe1ca-ccfpca-rcpsc-im

A 59-year-old man with long-term smoking presents with progressive dyspnoea. Spirometry shows FEV₁/FVC ratio 0.60 and FEV₁ 65% predicted. He has symptoms on exertion but no recent exacerbations. According to CTS COPD guidelines, what is the most appropriate initial long-acting pharmacologic therapy?

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