What should be done if there is no relief from symptoms in COPD patients with eosinophil counts less than 300?

In cases where COPD patients exhibit eosinophil counts below 300 and are not finding relief from their symptoms, the most appropriate course of action is to initiate triple therapy, which consists of a long-acting beta-adrenoceptor agonist (LABA), a long-acting muscarinic antagonist (LAMA), and an inhaled corticosteroid (ICS). This approach is supported by evidence indicating that escalating treatment to triple therapy can provide enhanced symptom control and improve lung function for individuals who are persistently symptomatic.

This comprehensive regimen targets multiple pathways involved in COPD, helping to reduce chronic inflammation, open the airways, and improve overall respiratory function. While continuation of current medications may seem reasonable, it may fail to adequately address the patient's ongoing symptoms. Switching to corticosteroids could be considered, but in the context of low eosinophil counts, it is not as supported as triple therapy for symptom relief. Increasing the dose of bronchodilators may provide marginal benefits, but it does not comprehensively tackle inflammation or obstructive airway issues that the combination of LABA, LAMA, and ICS would effectively manage.