Inhaled Therapy and Mortality in COPD

Combination therapy with fluticasone plus salmeterol was associated with reduced mortality, but the difference was just short of statistical significance.

It is unclear whether inhaled corticosteroids and long-acting β-agonists reduce mortality in patients with chronic obstructive pulmonary disease. In this industry-sponsored international trial (known as TORCH), researchers randomized more than 6000 COPD patients to receive inhaled salmeterol plus fluticasone (Advair 50/500), salmeterol (Serevent) alone, fluticasone (Flovent) alone, or placebo — all given twice daily. Enrollment criteria included a history of smoking, FEV₁ <60% of predicted, and reversibility with albuterol that was less than 10% of the patient's predicted FEV₁.

At 3 years, the following outcomes were noted:

All-cause mortality (the primary endpoint) was 12.6% with combined therapy, 13.5% with salmeterol, 16.0% with fluticason…

Reviewing Author

Allan S. Brett, MD