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Exacerbating COPD — SCE Respiratory MCQ

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HardCOPDExacerbating COPDSCE Respiratory

A 58-year-old man with COPD has persistent dyspnoea despite LABA/LAMA therapy and two moderate exacerbations in the past year. Blood eosinophils are 0.38 x 10^9/L, FEV1 is 42% predicted and he has no history of pneumonia. Inhaler technique and adherence are good. What is the most appropriate management?

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Correct answer: B — Escalate to inhaled corticosteroid, LABA and LAMA triple therapy

Frequent exacerbations despite dual bronchodilation and a raised eosinophil count make triple inhaled therapy appropriate. Maintenance oral prednisolone is not a routine COPD strategy because harms outweigh benefits. LTOT requires persistent hypoxaemia, and transplantation assessment is not the immediate step from these data.

Reference: https://www.brit-thoracic.org.uk/quality-improvement/guidelines/