For the first time, a drug therapy has been shown to slow the rate of lung function loss in patients with moderate to severe chronic obstructive pulmonary disease (COPD). Treatment with salmeterol (a long-acting inhaled beta2-agonist) and fluticasone propionate (an inhaled corticosteroid), either alone or together, significantly slowed the rate of decline in a large, randomized, double-blind, placebo-controlled trial spanning 42 countries.
The study, called TORCH (Towards a Revolution in COPD Health), involved more than 6,000 patients with moderate to severe COPD. The patients received salmeterol, fluticasone propionate, the two in combination, or a placebo. Researchers measured forced expiratory volume in 1 second (FEV1) at baseline and every 24 weeks after the start of therapy to determine the rate of decline in FEV1.
The rate of FEV1 decline was slowest in patients taking both drugs and fastest in those taking a placebo. The effect of treatment on FEV1 decline was similar regardless of smoking status, sex, age, baseline FEV1, ethnicity, body mass index, or previous exacerbations, researchers report. Until now, smoking cessation was the only treatment shown to slow the rate of decline in FEV1.
Celli BR, Thomas NE, Anderson JA, et al. Effect of pharmacotherapy on rate of decline of lung function in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2008;178(4):332-338; Suissa S.
Medications to modify lung function decline in chronic obstructive pulmonary disease: Some hopeful signs. Am J Resp Crit Care Med. 2008;178(4):322-323.