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Drugs 'can slow COPD'

A major, multicentre trial has become the first to demonstrate that a drug treatment can slow the progression of COPD.

The TORCH study found patients on a combination of salmeterol and fluticasone propionate had a markedly slower rate of decline of lung function than those on placebo.

The results, presented at the American Thoracic Society international conference in San Francisco this week, are the first robust, statistically significant data to show long-term benefit for drug treatment.

They follow previous findings, published in the New England Journal of Medicine in February, which suggested the combination cut mortality but fell just short of statistical significance.

Study author Dr Bartolome Celli, chief of pulmonary medicine at St Elizabeth's Medical Center in Boston, US, said: 'Until now, no intervention except smoking cessation has been shown to alter the rate of decline in lung function for patients with COPD.'

The study of 6,112 patients from 42 countries, funded by GlaxoSmithKline, found those treated with salmeterol/fluticasone propionate declined in lung function by 39ml per year, compared with 55ml per year with placebo.

It found patients who received either a ß-agonist or inhaled steroid alone also saw their decline in lung function slow, although by less than with the combination.

However, the National Prescribing Centre warned combination therapy significantly increased the risk of pneumonia and said the TORCH findings supported a 'cautious approach' to inhaled steroids in COPD.

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