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CORRESPONDENCE: J. Vestbo, North West Lung Research Centre, Wythenshawe Hospital, Manchester, M23 9LT, UK. Fax: 44 1612912832. E-mail: jvestbo@man.ac.uk
Keywords: Chronic obstructive pulmonary disease, fluticasone propionate, mortality, protocol, salmeterol, study design
Received: October 28, 2003
Accepted February 29, 2004
This study is funded by GlaxoSmithKline.
Abstract
Only long-term home oxygen therapy has been shown in randomised controlled trials to increase survival in chronic obstructive pulmonary disease (COPD). There have been no trials assessing the effect of inhaled corticosteroids and long-acting bronchodilators, alone or in combination, on mortality in patients with COPD, despite their known benefit in reducing symptoms and exacerbations. The "TOwards a Revolution in COPD Health" (TORCH) survival study is aiming to determine the impact of salmeterol/fluticasone propionate (SFC) combination and the individual components on the survival of COPD patients.
TORCH is a multicentre, randomised, double-blind, parallel-group, placebo-controlled study. Approximately 6,200 patients with moderate-to-severe COPD were randomly assigned to b.i.d. treatment with either SFC (50/500 µg), fluticasone propionate (500 µg), salmeterol (50 µg) or placebo for 3 yrs. The primary end-point is all-cause mortality; secondary end-points are COPD morbidity relating to rate of exacerbations and health status, using the St George's Respiratory Questionnaire. Other end-points include other mortality and exacerbation end-points, requirement for long-term oxygen therapy, and clinic lung function. Safety end-points include adverse events, with additional information on bone fractures.
The first patient was recruited in September 2000 and results should be available in 2006. This paper describes the "TOwards a Revolution in COPD Health" study and explains the rationale behind it.
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