Effect of Pharmacotherapy on Rate of Decline of Lung Function in Chronic Obstructive Pulmonary Disease Results from the TORCH Study

摘要: Rationale: Chronic obstructive pulmonary disease (COPD) is characterized by an accelerated decline in lung function. No drug has been shown conclusively to reduce this decline. Objectives :I n apost hoc analysis of the Toward a Revolution COPD Health (TORCH) study, we investigated effects combined salmeterol 50 mg plus fluticasone propionate 500 mg, either component alone or placebo, on rate post-bronchodilator FEV1 patients with moderate severe COPD. Methods: A randomized, double-blind, placebo-controlled study was conducted from September 2000 November 2005 42 countries. Of 6,112 efficacy population, 5,343 were included analysis. Measurements and Main Results: Spirometry measured every 24 weeks for 3 years. There 26,539 on-treatment observations. The adjusted 55 ml/year salmeterol, propionate, 39 propionate. Salmeterol reduced 16 ml/ year compared placebo (95% confidence interval [CI], 7–25;P , 0.001). difference smaller (13 ml/year; 95% CI, 5–22; P 5 0.003). Rates similar among active treatment arms. declined faster current smokers lower body mass index, varied between world regions. Patients who exacerbated more frequently had Conclusions: Pharmacotherapy components, reduces moderate-to-severe COPD, thus slowing progression. Clinical trial (GSK Study Code SCO30003) registered www. clinicaltrials.gov (NCT00268216).