Treatment with a commonly used drug slows the decline in lung function in patients with chronic obstructive pulmonary disease (COPD), according to results from the TORCH (TOwards a Revolution in COPD Health) study presented at the American Thoracic Society 2007 International Conference.
The study of 6,112 patients from 42 countries found that those treated with salmeterol/fluticasone propionate (Advair) had a slower rate of lung function decline compared with patients receiving a placebo over three years (39 vs. 55 milliliters per year).
"Until now, no intervention except smoking cessation has been shown to alter the rate of decline in lung function for patients with COPD," says one the study authors, Bartolome R. Celli, M.D., of St. Elizabeth's Medical Center in Boston. "This is the first time that pharmacotherapy has been shown to change the rate of decline in lung function."
Patients who received either the long-acting beta2-agonist salmeterol (Serevent) or the inhaled corticosteroid fluticasone propionate (Flovent) alone also had less of a decline in lung function than those receiving the placebo, but the decline was smaller than with the combined salmeterol/fluticasone propionate treatment.
The study also found that patients with a low body mass index (BMI) lose more lung function than those with a higher BMI.
The researchers also looked a geographic variations in lung function decline, and found that COPD patients who lived in East Asia and Eastern Europe lost lung function at a slower rate than those who lived in the United States or Western Europe. The study did not address the possible causes for this geographic difference.
The TORCH study is the largest ever, multicenter long-term COPD study. The study compared salmeterol at a dose of 50 mcg plus fluticasone propionate at a dose of 500 mcg twice daily combined in a single inhaler, with placebo, salmeterol alone, or fluticasone propionate alone for a period of three years.
In February 2007, the New England Journal of Medicine published results from the TORCH study that found that the reduction in death rates for patients taking the combination treatment was not significantly different from those in the placebo group. However, treatment with the combination treatment did result in significantly fewer COPD flareups and improved health-related quality of life and lung function, as compared with placebo.