A 66-year-old man with known COPD presents with worsening dyspnea and increased sputum production. Spirometry shows FEV1/FVC of 0.58 and FEV1 55% predicted. His current regimen is a LABA alone. The next best step is:
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A
Add a LAMA (tiotropium)
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B
Start systemic corticosteroids long-term
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C
Add theophylline
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D
Start inhaled corticosteroids alone