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

A 68-year-old man with a 40 pack-year smoking history presents with chronic cough and exertional dyspnoea. Spirometry shows FEV₁/FVC ratio 0.58 and FEV₁ 55% predicted. He has persisting dyspnoea despite using short-acting Salbutamol as needed. According to recent Canadian COPD pharmacotherapy guidance, which long-term inhaled regimen is most appropriate?

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