Question

A 68-year-old ex-smoker with chronic cough and exertional dyspnoea has spirometry showing FEV₁/FVC ratio 0.55 and FEV₁ 45% predicted, consistent with COPD. He uses a short-acting bronchodilator as needed but remains symptomatic with two exacerbations in the last year. According to NICE COPD guidance, what is the next most appropriate inhaled therapy?

Accepted Answer

Add a long-acting muscarinic antagonist and long-acting beta₂-agonist combination inhaler.

Answer

Add an inhaled corticosteroid alone.

Answer

Switch to a combined long-acting beta₂-agonist and inhaled corticosteroid inhaler.

Answer

Start oral Theophylline as first-line maintenance therapy.

Answer

Start chronic oral Prednisolone at low dose.

Practice question