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

A 68-year-old man with moderate COPD (FEV1 55 percent predicted) continues to report dyspnoea on exertion despite regular use of a long-acting muscarinic antagonist (LAMA). He has had one moderate exacerbation treated with oral prednisone in the last year. According to Canadian Thoracic Society COPD pharmacotherapy guidance, what is the most appropriate next step?

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