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Salmeterol and fluticasone propionate did not reduce mortality in chronic obstructive pulmonary disease

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 Q In patients with chronic obstructive pulmonary disease (COPD), do salmeterol (SA) and fluticasone propionate (FP) reduce mortality more than placebo?

Clinical impact ratings GP/FP/Primary care ★★★★★★★ IM/Ambulatory care ★★★★★★★ Respirology ★★★★★★☆

METHODS

Embedded ImageDesign:

randomised, 2x2 factorial design, placebo controlled trial (Towards a Revolution in COPD Health [TORCH] trial).

Embedded ImageAllocation:

unconcealed.*

Embedded ImageBlinding:

blinded (patients, healthcare providers, and outcome assessors).*

Embedded ImageFollow up period:

3 years.

Embedded ImageSetting:

444 centres in 42 countries.

Embedded ImagePatients:

6184 patients with COPD who were 40–80 years of age (about 76% men) and had a smoking history of ⩾10 packs/year, a pre-bronchodilator forced expiratory volume in 1 second (FEV1) <60% of the predicted value, an increase of FEV1 <10% after using albuterol 400 µg, and a ratio of pre-bronchodilator FEV1 to forced vital capacity ⩽0.7. Exclusion criteria included asthma; previous lung surgery or lung transplantation; requirement for long term (⩾12 h/d) oxygen therapy; alcohol, drug, or solvent abuse; hypersensitivity to …

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