Q. A 47-year-old man presents to the outpatient department with shortness of breath, wheezing, and chest tightness. He has a history of working as a chemical engineer for the past eight years. He reports that his symptoms started four years ago and have progressively worsened over time. He has difficulty breathing during the workweek and can breathe normally on weekends when he is away from the workplace. He has no significant past medical history, takes no medications and does not smoke. On physical examination, he is uncomfortable and relies on his accessory muscles to breathe. Lung examination reveals wheezing and decreased air entry in both lungs. Pulmonary Function Test (PFT) shows FEV1 2.5 L, FVC 3.5 L and FEV1/FVC Ratio of 70% while his eosinophil count is 1,200 cells/µL. Chest x-ray reveals hyperinflation and peri bronchial thickening. What is the most appropriate treatment for this patient?

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