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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
Design:
randomised, 2x2 factorial design, placebo controlled trial (Towards a Revolution in COPD Health [TORCH] trial).
Allocation:
unconcealed.*
Blinding:
blinded (patients, healthcare providers, and outcome assessors).*
Follow up period:
3 years.
Setting:
444 centres in 42 countries.
Patients:
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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