Practice question

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

A 70-year-old man with COPD (FEV₁ 45% predicted) has daily dyspnoea despite regular use of a LAMA inhaler and smoking cessation. He has had two moderate exacerbations requiring oral steroids and antibiotics in the past year. According to the 2023 CTS COPD pharmacotherapy guideline, which adjustment is most appropriate?

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