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Alpha-1 antitrypsin deficiency — SCE Respiratory MCQ

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HardCOPDAlpha-1 antitrypsin deficiencySCE Respiratory

A 44-year-old non-smoker with basal panacinar emphysema has confirmed severe PiZZ alpha-1 antitrypsin deficiency. In addition to standard COPD care and family counselling, what is the NICE position on intravenous augmentation therapy?

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

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Correct answer: A — Do not offer alpha-1 antitrypsin replacement therapy for COPD

Explanation lettering: C = shown as A · D = shown as B · A = shown as C · B = shown as D

C is correct. NICE does not recommend alpha-1 antitrypsin replacement therapy for COPD. Confirming severe deficiency remains important for smoking avoidance, optimisation of conventional COPD treatment, genetic counselling and testing of appropriate relatives, but it does not create an NHS augmentation indication. FEV1, exacerbation count and smoking status do not override this recommendation, and augmentation could not replace bronchodilation.

Reference: https://www.nice.org.uk/guidance/ng115/chapter/Recommendations