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Uncontrolled asthma — SCE Respiratory MCQ

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ModerateAsthmaUncontrolled asthmaSCE Respiratory

A 46-year-old teacher with confirmed asthma uses low-dose inhaled corticosteroid and salbutamol. She has symptoms on most days and two prednisolone-treated attacks in the past year; inhaler technique and adherence are good. FEV1 is 78% predicted and FeNO is 48 ppb. What is the most appropriate management?

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Correct answer: C — Switch to low-dose ICS/formoterol maintenance and reliever therapy

Persistent symptoms and attacks despite low-dose ICS are best managed by stepping up to an ICS/formoterol maintenance and reliever approach when suitable. Theophylline and maintenance oral prednisolone have greater toxicity and are not the next step after confirming adherence and technique. Increasing reliever reliance without anti-inflammatory escalation increases risk rather than addressing airway inflammation.

Reference: BTS/NICE/SIGN Asthma Guideline 2024; NICE NG245