Drug combo improves survival in patients with COPD

A combination of two common medications may help patients with chronic obstructive pulmonary disease (COPD) live longer. New research presented at CHEST 2006, the 72nd annual international scientific assembly of the American College of Chest Physicians (ACCP), shows that when used in combination, inhaled salmeterol (SAL) and fluticasone propionate (FP) reduced the risk of dying by up to 17.5 percent in patients with COPD. Currently, FP, an inhaled corticosteroid, and SAL, a long-acting B2-agonist bronchodilator, are used alone and in combination to treat both asthma and COPD.

"The combination therapy of salmeterol and fluticasone is the first intervention since oxygen therapy or smoking cessation to show improved survival in patients with COPD," said study author Bartolome R. Celli, MD, FCCP, of Caritas-St. Elizabeth's Medical Center, Boston, MA. "The improvement was comparable with that produced by statins in cardiovascular mortality. This represents an important step forward in the management of COPD."

As part of the TOwards a Revolution in COPD Health (TORCH) study, researchers from the United Kingdom, Denmark, Australia, and the United States investigated whether the combined therapy of salmeterol and fluticasone (FSC) would significantly impact survival in patients with COPD. Patients (n=6,112) with moderate to severe COPD from 42 countries were included in the 3-year, double-blind trial. Of the patients (76 percent men, mean age 65 years), 1,534 received FP; 1,521 received SAL; 1,533 received FSC; and the remaining patients received a placebo. Results were clinically significant, showing that FSC reduced the risk of dying at any time by 18 percent compared with placebo over the 3-year period, with absolute reduction rates being 15.2 percent and 12.6 percent, respectively. Secondary endpoints also were significant, including reduction in exacerbations, improvement in quality of life, and lung function. Furthermore, there was a trend in the

Contact: Jennifer Stawarz
American College of Chest Physicians

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