skip to main content

COPD inhaled corticosteroid pneumonia risk — GPhC CRA MCQ

Instant feedback + full explanation. One question, done properly.

HardRespiratory TherapeuticsCOPD inhaled corticosteroid pneumonia riskGPhC CRA

A person with COPD has taken LABA/LAMA/ICS triple therapy for a year. There is no asthmatic feature, blood eosinophils are low, symptoms did not improve after ICS was added and two radiologically confirmed pneumonias have occurred. What is the best next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Review withdrawal of inhaled corticosteroid while continuing LABA/LAMA

In a person without asthmatic features who has not benefited from ICS, recurrent pneumonia and low eosinophils weigh against continuing it. NICE supports reviewing treatment and considering monitored ICS withdrawal while maintaining long-acting bronchodilation, after checking diagnosis, adherence, exacerbation history and inhaler technique. Abrupt removal of effective LABA/LAMA therapy, ICS escalation or routine oral corticosteroid substitution is not supported by the scenario.

Reference: NICE NG115: Chronic obstructive pulmonary disease: https://www.nice.org.uk/guidance/ng115/chapter/Recommendations