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Asthma step-up therapy — GPhC CRA MCQ

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ModerateRespiratory TherapeuticsAsthma step-up therapyGPhC CRA

A 45-year-old woman with moderate persistent asthma is on beclometasone 400 micrograms daily and salbutamol as required. She remains symptomatic with daytime symptoms three times per week. Her inhaler technique has been checked and is satisfactory. What is the most appropriate next step?

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Correct answer: B — Add a long-acting beta-agonist such as formoterol

According to the BTS/SIGN and NICE asthma guidelines, the next step for a patient on low-dose ICS who remains symptomatic is to add a long-acting beta-agonist (LABA). If there is a good response, the ICS/LABA combination should be continued. Increasing ICS dose without first adding a LABA is not the recommended sequence. Theophylline and tiotropium are later-line options.

Reference: BTS/SIGN Guideline 158; NICE NG80