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COPD frequent exacerbations — RACP Written MCQ

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HardRespiratoryCOPD frequent exacerbationsRACP Written

A 69-year-old ex-smoker has COPD with two hospital-treated exacerbations in 12 months despite LAMA/LABA therapy. Blood eosinophils are 0.45 x 10^9/L, FEV1 is 42% predicted and CT shows emphysema without bronchiectasis. What is the most appropriate management?

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Correct answer: E — Add inhaled corticosteroid as part of triple therapy

Frequent exacerbations with a raised eosinophil count increase the likelihood of benefit from adding inhaled corticosteroid to dual bronchodilation.

Reference: Australian Asthma Handbook; TSANZ guidance; Therapeutic Guidelines: Respiratory