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Salmeterol Plus Fluticasone Propionate Effective in COPD NEW YORK -- August 15, 2008 -- For the first time, a drug therapy appears to reduce lung function loss in patients with moderate to severe chronic obstructive pulmonary disease (COPD), according to the results of a randomised, double-blind, placebo-controlled trial in 42 countries. The Toward a Revolution in COPD Health (TORCH) study investigated combined salmeterol (SAL), a beta-agonist, and fluticasone propionate (FP), an inhaled cortical steroid, either alone or in combination. The trial monitored treatment effects on mortality, exacerbations, health-related quality of life, and rate of decline in lung function as measure by forced expiratory volume in 1 second (FEV1) in patients with COPD. "Pharmacotherapy with salmeterol plus fluticasone propionate, or the components, reduces the rate of decline on FEV1 in patients with moderate to severe COPD, thus slowing disease progression," wrote lead author of the study Bartolome R. Celli, MD, Tufts University School of Medicine, Boston, Massachusetts. "To date, smoking cessation is the only intervention that has conclusively been shown to alter the rate of decline in FEV1," remarked Dr. Celli. This is the first demonstration of an effective pharmacotherapy in COPD. The TORCH study randomised more than 6,000 patients with moderate to severe COPD from 42 countries to receive either SAL, FP, the 2 in combination (SFC), or placebo. After baseline FEV1 was recorded, patients were re-evaluated every 24 weeks to determine the rate of decline in FEV1. "The rate of decline in FEV1 was slowest in patients on SFC and fastest in those randomised to the placebo arm," wrote Dr. Celli. "From week 24 onward, the adjusted rate of decline in FEV1 was 39 mL/year for SFC, 42 mL/year for both SAL and FP, and 55 mL/year for placebo." "The TORCH study brings some clarity to the treatment picture and provides some hopeful signs for patients with COPD," wrote Samy Suissa, PhD, McGill University, Montreal, Canada, in an accompanying editorial. "This study also demonstrates that no treatment is not an option for patients with moderate to severe COPD." SOURCE: American Thoracic Society E-mail this page to a friend or colleague! To print, use this version