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Drug Combo Halves Death Risk for Severe COPD Patients

Salmeterol plus fluticasone therapy led to better health, large trial finds

FRIDAY, Dec. 28 (HealthDay News) -- People suffering with chronic obstructive pulmonary disease (COPD) may find that combining two currently available medications halves their risk of death within two years as well and improves their overall health status and quality of life, new research suggests.

The conclusion is drawn from the first human trial to compare treatment of COPD with a combination of salmeterol and fluticasone [SFC] to tiotropium therapy. The medications in the study are currently prescribed to improve breathing among patients with COPD or asthma.

COPD, a chronic disease that makes it difficult to breathe easily, is the fourth leading cause of death in the United States. More than 11 million people are diagnosed with the condition, according to the American Lung Association.

"Although we found no difference in the overall rate of exacerbations between treatment groups, SFC treatment was associated with better health status, fewer patient withdrawals, and a lower mortality rate than occurred during tiotropium therapy," study author Dr. Jadwiga Wedzicha, of the Royal Free & University College Medical School in London, said in a prepared statement.

Writing in the January issue of the American Journal of Respiratory and Critical Care Medicine, researchers described the results of a two-year trial of SFC or tiotropium for 1,323 patients with severe COPD. The researchers analyzed number and type of exacerbations, health status, lung function and study withdrawal rate. Patients were randomly assigned to one of the two treatment plans, and neither they nor their doctors knew which treatment they were receiving.

Exacerbations are periods of time when people with COPD have a harder time breathing freely, characterized by wheezing, coughing and shortness of breath. People may need medical assistance during an exacerbation. Neither treatment was more successful in reducing the number of exacerbations patients experienced, although the researchers noted that oral steroids were used more often to control exacerbations among people taking tiotropium. People on SFC were more likely to require antibiotics.

However, patients in the SFC arm of the trial were 50 percent less likely to die from any cause during the two years of the study. They were also less likely to drop out of the trial.

The researchers called for further research to understand the mechanisms behind the therapies.

More information

To learn more about COPD, visit the American Lung Association.

-- Madeline Vann

SOURCE: American Thoracic Society, news release, Dec. 28, 2007

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