COPD daily management should include which of the following?

• A. LABA, tiotropium, steroids
• B. SABA, inhaled steroids
• C. LABA only
• D. Tiotropium only

Answer: (A)

In COPD, daily management aims to maximize ongoing bronchodilation to reduce symptoms and prevent exacerbations. Using a long-acting bronchodilator is essential, and combining therapies often provides better control than a single agent. When symptoms or exacerbations persist despite dual bronchodilation, adding an inhaled corticosteroid targets airway inflammation and further lowers the risk of future flares. This triple approach—a long-acting beta-agonist plus a long-acting muscarinic antagonist plus an inhaled corticosteroid—can offer the best overall control for many patients with more advanced disease or frequent exacerbations. It’s not used indiscriminately, because inhaled steroids carry risks such as pneumonia, so they’re reserved for those with recurrent exacerbations or higher inflammatory phenotypes.