 |
|
Hope for patients with COPD
August 15, 2008For the first time, a drug therapy appears to reduce lung function loss in patients with moderate to severe chronic obstructive pulmonary disease (COPD), according to the results of a randomized, double-blind, placebo-controlled trial in 42 countries.
The Toward a Revolution in COPD Health (TORCH) study investigated the effects of combined salmeterol, a ß-agonist, and fluticasone propiniate, an inhaled cortical steroid, either alone or in combination, on mortality, exacerbations, health-related quality of life and rate of decline in lung function as measure by forced expiratory volume in one second (FEV1) in patients with COPD.
The results are published in the second issue for August of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
"Pharmacotherapy with salmeterol plus fluticasone propionate, or the components, reduces the rate of decline on FEV1 in patients with moderate to severe COPD, thus slowing disease progression," wrote Bartolome R. Celli, M.D., lead author of the study and professor at Tufts University School of Medicine. "To date, smoking cessation is the only intervention that has conclusively been shown to alter the rate of decline in FEV1," remarked Dr. Celli. This is the first demonstration of an effective pharmacothrerapy in COPD.
The TORCH study randomized more than 6,000 patients with moderate to severe COPD from 42 countries to receive either salmeterol (SAL; 50 g), fluticasone propionate (FP; 500 g), the two in combination (SFC; 50/500g), or placebo. After baseline FEV1 was recorded, patients were re-evaluated every 24 weeks to determine the rate of decline in FEV1.
"The rate of decline in FEV1 was slowest in patients on SFC and fastest in those randomized to the placebo arm," wrote Dr. Celli. "From week 24 onward, the adjusted rate of decline in FEV1 was 39ml/year for SFC, 42 ml/year for both SAL and FP and 55 ml/year for placebo."
Although the study was not formally powered to detect differences in rate of decline of FEV1, the results were highly significant (p<0.001.) The rate of decline in treatment groups was similar across a number of variables, including sex, age, ethnicity and body mass index. Furthermore, the slower rate of decline in FEV1 appeared to be associated with a lower risk of exacerbation.
"Although treatment did not abolish the accelerated decline in lung function [that occurs with COPD], it did ameliorate it substantially," wrote Dr. Celli, while noting that "the mechanism responsible for the effect on rate of decline is not clear, as all treatments have potentially significant nonbronchodilator effects." Clarifying those mechanisms is the goal of the next phase of the research, with the comparison between a long-acting bronchodilator drug and placebo with respect to FEV1 decline.
In the meantime, "the TORCH study brings some clarity to the treatment picture and provides some hopeful signs for patients with COPD," wrote Samy Suissa, Ph.D., of McGill University, in the accompanying editorial. "This study also demonstrates that no treatment [placebo] is not an option for patients with moderate to severe COPD."
American Thoracic Society
"Pharmacotherapy with salmeterol plus fluticasone propionate, or the components, reduces the rate of decline on FEV1 in patients with moderate to severe COPD, thus slowing disease progression," wrote Bartolome R. Celli, M.D., lead author of the study and professor at Tufts University School of Medicine. "To date, smoking cessation is the only intervention that has conclusively been shown to alter the rate of decline in FEV1," remarked Dr. Celli. This is the first demonstration of an effective pharmacothrerapy in COPD.
The TORCH study randomized more than 6,000 patients with moderate to severe COPD from 42 countries to receive either salmeterol (SAL; 50 g), fluticasone propionate (FP; 500 g), the two in combination (SFC; 50/500g), or placebo. After baseline FEV1 was recorded, patients were re-evaluated every 24 weeks to determine the rate of decline in FEV1.
"The rate of decline in FEV1 was slowest in patients on SFC and fastest in those randomized to the placebo arm," wrote Dr. Celli. "From week 24 onward, the adjusted rate of decline in FEV1 was 39ml/year for SFC, 42 ml/year for both SAL and FP and 55 ml/year for placebo."
Although the study was not formally powered to detect differences in rate of decline of FEV1, the results were highly significant (p<0.001.) The rate of decline in treatment groups was similar across a number of variables, including sex, age, ethnicity and body mass index. Furthermore, the slower rate of decline in FEV1 appeared to be associated with a lower risk of exacerbation.
"Although treatment did not abolish the accelerated decline in lung function [that occurs with COPD], it did ameliorate it substantially," wrote Dr. Celli, while noting that "the mechanism responsible for the effect on rate of decline is not clear, as all treatments have potentially significant nonbronchodilator effects." Clarifying those mechanisms is the goal of the next phase of the research, with the comparison between a long-acting bronchodilator drug and placebo with respect to FEV1 decline.
In the meantime, "the TORCH study brings some clarity to the treatment picture and provides some hopeful signs for patients with COPD," wrote Samy Suissa, Ph.D., of McGill University, in the accompanying editorial. "This study also demonstrates that no treatment [placebo] is not an option for patients with moderate to severe COPD."
American Thoracic Society
Chronic Obstructive Pulmonary Disease Current Events and Chronic Obstructive Pulmonary Disease News RSSLong-term antibiotics reduce COPD exacerbations, raise questions
Long-term use of a macrolide antibiotic may reduce the frequency of exacerbations in patients with moderate to severe chronic obstructive pulmonary disease (COPD) by as much as 35 percent, according to a London-based study.
Hospital visits for respiratory illnesses spiked during Southern California wildfires
Raging wildfires that engulfed Southern California earlier this decade not only destroyed neighborhoods laying in their path, they also caused significant health problems for many who lived outside the fires' reach.
Cold virus found to manipulate genes
Sneezing, runny nose and chills? You might blame the human rhinovirus (HRV), which causes 30 to 50 percent of common colds. But in reality, it's not the virus itself but HRV's ability to manipulate your genes that is the true cause of some of the most annoying cold symptoms.
Depression may increase exacerbations, hospitalizations in COPD
It is well known that patients with chronic obstructive pulmonary disease (COPD) frequently suffer from depression and anxiety, but according to new research, depression and anxiety may actually cause increased hospitalizations and exacerbations.
First comprehensive genomic study of common cold reveals new treatment targets
Today, scientists from Procter & Gamble (P&G), the University of Calgary and the University of Virginia announced results from the first study to examine the entire human genome's response to the most common cold virus, human rhinovirus.
UCSF Fresno leading-edge study lends hope to emphysema patients
Patients in the Valley with emphysema might soon be breathing a little easier thanks to a new airway bypass study called the Exhale Airways Stents for Emphysema (EASE) trial.
RSV may hide in the lungs, lead to asthma, UT Southwestern researchers report
Conventional wisdom has been that respiratory syncytial virus (RSV) - a common virus that causes infection in the lungs - comes and goes in children without any long lasting impact.
Stress tests to confirm need for cardiac stent not occurring in most patients, new study finds
UCSF researchers investigating the appropriate use of procedures to open narrowed coronary arteries -- such as angioplasty and stenting -- found that less than half of Medicare patients had documented noninvasive stress testing prior to elective percutaneous coronary intervention, or PCI, the clinical name for such procedures.
Death rate 70 percent lower at top-rated hospitals: HealthGrades annual hospital quality study
Patients have on average a 70 percent lower chance of dying at the nation's top-rated hospitals compared with the lowest-rated hospitals across 17 procedures and conditions analyzed in the eleventh annual HealthGrades Hospital Quality in America Study, issued today by HealthGrades, the leading independent healthcare ratings organization.
Red wine may lower lung cancer risk
Moderate consumption of red wine may decrease the risk of lung cancer in men, according to a report in the October issue of Cancer Epidemiology, Biomarkers & Prevention¸ a journal of the American Association for Cancer Research.
More Chronic Obstructive Pulmonary Disease Current Events and Chronic Obstructive Pulmonary Disease News Articles
 | Life and Breath: Preventing, Treating and Reversing Chronic Obstructive Pulmonary Disease by Neil Schachter The fourth leading cause of death in the United States, COPD, or chronic obstructive pulmonary disease, affects an estimated 35 million Americans. Yet only half are aware that they are seriously ill. Life and Breath, by Dr. Neil Schachter, is the first book that alerts people to their risks for COPD and explains the steps they need to take to prevent the development of this debilitating and often... |
 | Coping with COPD: Understanding, Treating, and Living with Chronic Obstructive Pulmonary Disease by Elaine Fantle Shimberg The first hands-on guide to living and coping with an insidious disease that affects tens of millions of peopleExperts estimate that as many as thirty-five million Americans literally cannot catch their breath-they are suffering from Chronic Obstructive Pulmonary Disease. The fourth-leading cause of death in America, COPD is a combination of chronic bronchitis and emphysema with airflow... |
 | Pharmacotherapy in Chronic Obstructive Pulmonary Disease (Lung Biology in Health and Disease) Placing specialists at the cutting-edge of therapeutic and biotechnological research, this reference reviews the extensive array of pharmaceutical options available for the management of patients with COPD. The book considers disease severity, dosing regimens, administration methods, and monitoring procedures, as well as medication-related side-effects for improved lung function, reduction of... |
 | 21st Century Complete Medical Guide to Chronic Obstructive Pulmonary Disease (COPD) and Emphysema, Authoritative Government Documents, Clinical References, ... for Patients and Physicians (CD-ROM) by PM Medical Health News This up-to-date electronic book on CD-ROM provides the best collection available anywhere of official Federal government information and documents on the subject of COPD (Chronic Obstructive Pulmonary Disease) and emphysema. This CD-ROM uses next-generation search technology that allows complete indexing and makes all files on the disc fully searchable. For patients, practical information is... |
 | Acute Exacerbations of Chronic Obstructive Pulmonary Disease (Lung Biology in Health and Disease) This text aids practitioners who seek to diagnose, treat and manage patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) more effectively. It discusses pulmonary gas exchange, muscle function and breathing, water/electrolyte imbalances and end-stage... |
 | Chronic Obstructive Pulmonary Disease The only international clinical textbook for COPD – one of the top 5 causes of death and disability worldwideThe only COPD textbook to include the latest national and international guidelines and the newer therapeutic agents in COPD treatmentInternational team of contributors covers all aspects of COPD – from physiology and epidemiology to diagnosis and treatmentEverything the busy physician... |
 | Clinical Management of Chronic Obstructive Pulmonary Disease (Lung Biology in Health and Disease) by SimiloWski/Whit This reference presents a comprehensive review of the most recent strategies used to assess, treat, and manage patients in each phase of chronic obstructive pulmonary disease (COPD)-offering the latest diagnostic modalities to identify and distinguish components of COPD in earlier, more reversible stages. Detailing the latest imaging advances, management tools, and follow-up procedures for... |
 | Chronic Obstructive Pulmonary Disease Exacerbations (Lung Biology in Health and Disease) Exacerbations of Chronic Obstructive Pulmonary Disease (COPD) covers the definition, diagnosis, epidemiology, mechanisms, and treatment associated with COPD exacerbations. This text also addresses imaging, and how it plays a pivotal role in the diagnosis and study of exacerbations. Written by today’s top experts, Exacerbations of Chronic Obstructive Pulmonary Disease... |
 | Atlas of Chronic Obstructive Pulmonary Disease The Atlas of Chronic Obstructive Pulmonary Disease is a comprehensive collection of high-quality images covering all areas of COPD. Included are radiographic images, flow charts, schematics, anatomic illustrations, graphs, tables, charts, and slides of pathologic and histologic specimens. Each figure is accompanied by an informative legend that fully explains the image and its importance. From... |
 | Managing Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease (COPD) is increasing rapidly worldwide and it's predicted that by 2020 it will represent the third leading cause of death. Sadly, this slow-progressing debilitating disease not only affects the individual but also has consequences for the family. More positively, the urgent need to improve the care offered and to raise the public profile of the condition has... |
| © 2008 BrightSurf.com |