Vilanterol and Fluticasone for COPD: No Mortality Benefit

Cardiovascular (CV) disease is a leading cause of death in patients with moderate chronic obstructive pulmonary disease (COPD). In the TORCH trial, mortality was lower in patients treated with fluticasone plus salmeterol (Advair) compared with placebo (12.6% vs. 15.2%), but this fell just short of statistical significance (P=0.052; NEJM JW Gen Med Mar 15 2007 and N Engl J Med 2007; 356:775). However, post hoc analysis of TORCH suggested fewer cardiovascular (CV) deaths with Advair than with placebo. That observation provided the rationale for this industry-funded randomized trial in which nearly 16,500 patients with moderate COPD who had (or were at high risk for) CV disease received once daily inhaled fluticasone furoate (Arnuity Ellipta; …